Outcomes of primary membranous nephropathy based on serum anti-phospholipase A2 receptor antibodies and glomerular phospholipase A2 receptor antigen status: a retrospective cohort study.

INTRODUCTION: Primary membranous nephropathy (PMN) is associated with the anti-phospholipase A2 receptor (anti-PLA2R) antibody in 70% of cases. Some anti-PLA2R-negative patients have the PLA2R antigen in renal tissue. This study examined the prognosis of patients with PMN according to their serum anti-PLA2R antibody (SAb) and glomerular PLA2R antigen (GAg) status. METHODS: Patients diagnosed with PMN were included retrospectively. Patients were grouped according to their PLA2R status into the SAb-/GAg-, SAb-/GAg+, and SAb+/GAg + groups. Baseline data, renal biopsy results, treatment, and clinical data were compared among the groups. Cox univariable and multivariable analyses examined the factors related to complete remission (CR). RESULTS: A total of 114 patients were enrolled; 10 (9%) in the SAb-/GAg-, 23 (20%) in the SAb-/GAg+, and 81 (71%) in the SAb+/GAg+ groups. Cumulative CR rate showed a significant difference between the SAb-/GAg - and SAb+/GAg+ groups (log-rank p = 0.003). The multivariable Cox proportional hazard analysis showed that age (HR = 0.968; 95%CI = 0.946-0.990; p = 0.005), SAb+/GAg+ versus SAb-/GAg- (HR = 0.387; 95%CI = 0.190-0.788; p = 0.009), SAb-/GAg+ versus SAb-/GAg- (HR = 0.398; 95%CI = 0.169, 0.939; p = 0.035), total renal chronicity score ≥2 (HR = 0.461, 95%CI: 0.277-0.766, p = 0.003), and IgA deposition (HR = 2.596; 95%CI = 1.227-5.492; p = 0.013) were all independently related (p < 0.05) to CR. CONCLUSIONS: The SAb and GAg status was an indicator of PMN prognosis. The patients with SAb-/GAg - had an increased likelihood of achieving CR than those with SAb-/GAg+ and SAb+/GAg+.

[Factors affecting quality of life of patients with gastrointestinal cancer].

BACKGROUND & OBJECTIVE: The evaluation of quality of life (QOL) has been used widely in cancer research, and the research of QOL for cancer patients makes more and more effect on the improvement of cancer treatment. This study was to evaluate the QOL of patients with gastric cancer or colorectal cancer, and to investigate the factors affecting their QOL. METHODS: Structured questionnaire EORTC QLQ C30 was used to evaluate the QOL of 52 gastric cancer patients and 50 colorectal cancer patients from Feb. 1, 2005 to Aug. 31, 2006. The QOL were compared by t test and one-way analysis of variance (ANOVA). The correlations of the items, facets, and domains of EORTC QLQ C30 to clinical stage were analyzed by optimal scaling regression and discriminant analysis. The correlations of the items, facets, and domains of EORTC QLQ C30 to overall QOL were analyzed by multiple linear regression analysis. RESULTS: The patients at early stages, or with higher education, or received combined treatment, had high functional scale and global health status (GH)/QOL score and low symptom scale and single item score, and had better QOL. Age and sex had no influence on QOL. GH scores of gastric cancer patients were lower than those of colorectal cancer patients, indicating that the QOL of gastric cancer patients was poorer than the QOL of colorectal cancer patients. CONCLUSION: Clinical stage, education, and treatment pattern are important factors affecting the QOL of patients with gastrointestinal cancer.