RESUMO
BACKGROUND: Primary cardiac tumors are rare, but few studies have examined the relationship between risk factors and the prognosis. The aim of this study was to provide a survival analysis and risk factors for mortality in patients with primary cardiac tumors. METHODS: We retrospectively enrolled 71 patients diagnosed with primary cardiac tumors from June 2006 to November 2017 in our hospital. Patients' population characteristics, treatment information, pathology, and follow-up data were obtained and analyzed. RESULTS: Of the 71 patients, 60 cases were benign, and 11 cases were malignant. Sex, age, New York Heart Association classification, the percentage of peripheral embolism, and surgery had no significant difference between benign and malignant groups (P >.05), but the percentage of arrhythmia, leg edema, and mortality rate was higher in the malignant tumor group than in the benign tumor group (P <.05). Compared with the benign tumor group, the percentage of biatrial lesions in the malignant tumor group was significantly higher (P <.05). Moreover, Independent risk factors included the treatment choice, pathology type, and number of tumor lesions (P <.05). CONCLUSION: Our study suggests that conservative therapy, malignant cardiac tumor, and biatrial tumor lesion are independent risk factors for poor prognosis.
Assuntos
Neoplasias Cardíacas/mortalidade , Neoplasias Cardíacas/cirurgia , Adulto , China , Feminino , Neoplasias Cardíacas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de SobrevidaRESUMO
BACKGROUND: Cardiac myxoma is the most common primary cardiac tumor. Approximately 75-80% of myxomas are located in the left atrium. Occurrence of multiple myxomas is extremely rare. CASE PRESENTATION: We describe a rare case of biventricular myxomas resulting in right ventricular inflow and tricuspid valve obstruction. The lesions were detected by echocardiography and thoracic computerized tomography (CT) and confirmed on positron emission tomography-computed tomography. CONCLUSION: The patient underwent successful surgical resection of the multiple cardiac myxomas. This kind of biventricular case has not been previously reported. The patient is asymptomatic as of the 10-month follow-up.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Neoplasias Cardíacas/cirurgia , Mixoma/cirurgia , Adolescente , Ecocardiografia , Feminino , Neoplasias Cardíacas/diagnóstico , Ventrículos do Coração , Humanos , Mixoma/diagnóstico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia Computadorizada por Raios XRESUMO
Currently, whether endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is superior to conventional TBNA (cTBNA) in the diagnosis of mediastinal lymphadenopathy remains controversial. We undertook a meta-analysis of randomized controlled trials (RCTs) to evaluate the diagnostic yield of EBUS-TBNA versus cTBNA in the diagnosis of mediastinal lymphadenopathy, both in benign and malignant etiologies. Computer-based retrieval was performed on PubMed and EMBASE. The quality was evaluated according to the quality assessment of diagnostic accuracy studies-2, and Meta-Disc was adopted to perform meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95 % confidence intervals (CIs) were calculated. The summary receiving operating characteristic curve as well as the areas under curve (AUC) was measured. Four studies with a total of 440 patients met the inclusion criteria. Our results showed that the pooled sensitivity was 0.90 (95 % CI 0.85-0.94) and 0.76 (95 % CI 0.68-0.82), pooled specificity was 0.75 (95 % CI 0.60-0.87) and 0.94 (95 % CI 0.86-0.98), DOR was 75.38 (95 % CI 16.38-346.97) and 108.17 (95 % CI 13.84-845.35), and AUC was 0.9339 and 0.9732 for EBUS-TBNA group and cTBNA group, respectively. Although EBUS-TBNA with a higher sensitivity performs better than cTBNA, there is lack of enough evidence regarding EBUS-TBNA being superior to cTBNA in the diagnosis of mediastinal lymphadenopathy. Considering the limitations of methodology and limited data, further robust RCTs are needed to verify the current findings and investigate the optimal choice in patients receiving TBNA.
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BACKGROUND: Associations between elevated C-reactive protein (CRP) and cancer risk have been reported for many years, but the results from prospective cohort studies remains controversial. A meta-analysis of prospective cohort studies was therefore conducted to address this issue. METHODS: Eligible studies were identified by searching the PubMed and EMBASE up to October 2012. Pooled hazard ratios (HR) was calculated by using random effects model. RESULTS: Eleven prospective cohort studies involving a total of 194,796 participants and 11,459 cancer cases were included in this meta-analysis. The pooled HR per natural log unit change in CRP was 1.105 (95% confidence interval (CI): 1.033-1.178) for all-cancer, 1.308 (95% CI: 1.097-1.519) for lung cancer, 1.040 (95% CI: 0.910-1.170) for breast cancer, 1.063 (95% CI: 0.965-1.161) for prostate cancer, and 1.055 (95% CI: 0.925-1.184) for colorectal cancer. Dose-response analysis showed that the exponentiated linear trend for a change of one natural log unit in CRP was 1.012 (95% CI: 1.006-1.018) for all-cancer. No evidence of publication bias was observed. CONCLUSIONS: The results of this meta-analysis showed that the elevated levels of CRP are associated with an increased risk of all-cancer, lung cancer, and possibly breast, prostate and colorectal cancer. The result supports a role of chronic inflammation in carcinogenesis. Further research effort should be performed to identify whether CRP, as a marker of inflammation, has a direct role in carcinogenesis.
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Proteína C-Reativa/metabolismo , Neoplasias/sangue , Neoplasias/epidemiologia , Estudos de Coortes , Intervalos de Confiança , Humanos , Inflamação/sangue , Inflamação/epidemiologia , Fatores de RiscoRESUMO
OBJECTIVE: To investigate the effect of liver X receptor agonist T0901317 on transforming growth factor-ß1 (TGF-ß1)-induced expression of α-smooth muscle actin (α-SMA) in normal human lung fibroblasts. METHODS: Primary normal human lung fibroblast isolated from the lung specimens of lung cancer patients by explant culture technique were identified with immunostaining for vimentin and keratin. The cells in passages 4 to 10 were treated with T0901317 and/or TGF-ß1, and RT-PCR, Western blotting and immunofluorescence assay were used to detect α-SMA expression in the fibroblasts. RESULTS: Lung fibroblast expressed vimentin but not keratin. The results of RT-PCR, Western blotting and immunofluorescence assay all showed that normal human lung fibroblasts constitutively expressed α-SMA under baseline condition, and TGF-ß1 at 5 ng/ml induced a significant upregulation of α-SMA both at the mRNA and protein levels. Liver X receptor agonist T0901317 (5 µg/ml) significantly inhibited TGF-ß1-induced upregulation of α-SMA expression. CONCLUSION: Liver X receptor agonist T0901317 can inhibit the upregulation of α-SMA in normal human lung fibroblasts induced by TGF-ß1, suggesting the potential value of liver X receptor agonist in the treatment of lung fibrosis.
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Actinas/metabolismo , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Hidrocarbonetos Fluorados/farmacologia , Sulfonamidas/farmacologia , Fator de Crescimento Transformador beta1/farmacologia , Células Cultivadas , Feminino , Humanos , Receptores X do Fígado , Pulmão/citologia , Pessoa de Meia-Idade , Receptores Nucleares Órfãos/agonistas , RNA Mensageiro/genéticaRESUMO
OBJECTIVE: To analyze the clinical diagnosis and treatment of hepatic hydatid disease and its epidemiological characteristics in Yili river valley. METHODS: Retrospective investigation was carried out on 2049 cases collected in 1993-2003. Clinical diagnosis was made by ways of intradermal test, serological test, ultrasound, X-ray, CT and/or MRI, majority of them received surgical operation. RESULTS: Among the 2049 cases, cystic hydatidosis occupied 96% (1965/2049), while 4% (84/2049) were alveolar hydatidosis. 99% (2034/2049) accepted surgery including hepatolobectomy, endocystomy and hydatidostomy in 302 cases (14.7%) without relapses. 754 cases (36.7%) received chemotherapy (praziquantel, albendazole) after surgical operation. The disease distributed in agri-pastoral areas along the valley. Local residents from different minorities had a close contact with dogs, 54% of the cases were females and 48% of the cases were in the group of 25-49 years old. The incidence tends to decline in the years. CONCLUSION: Hydatidosis is still an important health problem in the region. Further practices for improving treatment especially surgical intervention and for epidemiological investigation are needed.