Résumé
Objective To analyze the prognostic influencing factors of pulmonary adenocarcinoma with a micropapillary pattern (MPPAC).Methods A total of 109 MPPAC patients who received surgical operation in Shandong Cancer Hospital Affiliated to Shandong University from August 2012 to August 2015 were retrospectively analyzed.The median survival time and the survival rate of 1-,3-and 5-year were calculated by using Kaplan-Meier method,log-rank test was used for single-factor analysis and Cox regression analysis was used for multiple-factor analysis.Results The median overall survival time of 109 MPPAC patients was 55.0 months (3-67 months).The overall survival rate of 1-,3-and 5-year was 89.0%,61.5%,48.6%,respectively.Single factor analysis showed that the gender (x2 =7.208,P =0.007),the tumor size (x2 =24.083,P < 0.01),lymph node metastasis (x2 =23.068,P < 0.01),vascular tumor thrombosis (x2 =16.411,P < 0.01),visceral pleural infiltration (x2 =18.438,P < 0.01) and multiple tumors (x2 =28.563,P <0.01) were associated with the overall survival of MPPAC patients.Multiple factor analysis showed that the tumor size (RR =1.629,95% CI 1.145-2.317,P =0.007),lymph node metastasis (RR =1.680,95% CI 1.161-2.430,P =0.006) and vascular tumor thrombosis (RR =2.867,95% CI 1.286-6.392,P =0.010) were the independent prognosis factors for MPPAC patients.Conclusion The MPPAC patients have a poor prognosis.The tumor size,lymph node metastasis and vascular tumor thrombosis could influence the prognosis of MPPAC patients.
Résumé
Objective To explore the expression of DKK-1 and its clinical value in patients with e-sophageal cancer. Methods The levels of serum DKK-1 were measured by sandwich enzyme linked immu-nosorbent assay(ELISA) in 80 patients with esophageal squamous cell cancer and in 35 healthy subjects. The sensitivities of serum DKK-1, CEA and CYFRA21-1 in the patients with esophageal squamous cell cancer were calculated and analyzed to compare their values in diagnosis of esophageal cancer. Results The serum DKK- 1 levels in patients with esophageal squamous cell cancer were significantly higher than those of healthy subjects(P<0.05). According to the highest value of medicine reference of DKK- 1 (14. 54 ng/ml), its sensitivity and specificity were 66. 25% and 82. 86% respectively; There was a significant difference between the sensitivity of DKK-1 in patients with esophageal squamons cell cancer(66. 25%) and that in healthy subjects(17.14%) (P<0.05). The sensitivitis of serum DKK- 1 in patients with esophageal squamous cell cancer were associated with tumor size, TNM stage and lymph node metastasis(P <0.05),but not associated with gender,age and differentiation grade(P>0.05). And the sensitivity of DKK-1 (66. 25%) was significantly higher than that of CEA, CYFRA21-1 (39. 44% ,25. 35%, P <0. 01). Conclusion DKK-1 played a very important role in the growth and metastasis of esophageal cancer and may be a new tumor marker or an important index in the diagno-sis of esophageal cancer.
Résumé
Recently, with the development of techniques such as proteomics, the positive rate of com-mon tumor markers, such as carcinoembryonic antigen (CEA) and squamous cell carcinomatous antigen (Scc-Ag) has increased obviously. And some new tumor markers related to esophageal carcinoma (EC) have been detected, such as vascular endothelial growth factor, angiopoietin, Dickkopf21, tumor M2-PK and etc. Clinical trials are undergoing to estimate the value of these markers,which may change the current status of EC diagnosis and therapy.