Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 252
Filtrar
1.
Aging (Albany NY) ; 122020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32045885

RESUMO

Gait disturbance is considered to be a significant clinical manifestation of cerebral small vessel disease (CSVD). We aimed to investigate the association between different imaging markers of CSVD or total CSVD burden and gait disturbance in a community-dwelling population. In the cross-sectional Taizhou Imaging Study (TIS), 314 participants free of neurological disorders underwent MRI scanning and gait assessment with quantitative wearable devices as well as clinical rating scales. In linear regression, after adjustment for demographics and vascular risks, total CSVD burden was associated with prolonged 3-m walking (ß=0.118, P=0.035), shorter stride length (ß=-0.106, P=0.042), and poorer Timed-Up-and-Go (TUG) performance (ß=0.146, P=0.009). Lacunes were positively associated with 3-m walking (ß=0.118, P=0.037) and duration of TUG test (ß=0.112, P=0.047). White matter hyperintensities and cerebral microbleeds were associated with prolonged stride time (ß=0.134, P=0.024) and increased stance phase time percentage (ß=0.115, P=0.038), respectively. Logistic regression revealed that participants with high CSVD burden or more lacunes were more likely to have an impaired gait velocity and an impaired TUG test. These results suggest that total CSVD burden and CSVD imaging markers are associated with gait disturbance among community-dwelling elderly people. Different CSVD imaging markers may cause gait disturbance through different pathways.

2.
Plant Cell ; 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32051210

RESUMO

Starch is the major storage carbohydrate in plants and functions in buffering carbon and energy availability for plant fitness with challenging environmental conditions. The timing and extent of starch degradation appears to be determined by diverse hormonal and environmental signals. However, our understanding of the regulation of starch metabolism is fragmentary. Here, we demonstrate that phytohormone brassinosteroid (BR) and redox signal hydrogen peroxide (H2O2) induce the breakdown of starch in guard cells, which promotes stomatal opening. The BR-insensitive mutant bri1-116 accumulated high levels of starch in guard cells, impairing stomatal opening in response to light. The gain-of-function mutant bzr1-1D suppressed the starch excess phenotype of bri1-116, thereby promoting stomatal opening. BRASSINAZOLE-RESISTANT 1 (BZR1) interacts with the bZIP transcription factor G-BOX BINDING FACTOR2 (GBF2) to promote the expression of ß-AMYLASE1 (BAM1), which is responsible for starch degradation in guard cells. H2O2 induces the oxidation of BZR1, enhancing the interaction between BZR1 and GBF2 to increase BAM1 transcription. Mutations in BAM1 lead to starch accumulation and reduce the effects of BR and H2O2 on stomatal opening. Overall, the present study uncovers the critical roles of BR and H2O2 in the regulation of guard cell starch metabolism and stomatal opening.

3.
Sci Rep ; 10(1): 614, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31953486

RESUMO

Toxicity to central nervous system tissues is the common side effects for radiotherapy of brain tumor. The radiation toxicity has been thought to be related to the damage of cerebral endothelium. However, because of lacking a suitable high-resolution vivo model, cellular response of cerebral capillaries to radiation remained unclear. Here, we present the flk:eGFP transgenic zebrafish larvae as a feasible model to study the radiation toxicity to cerebral capillary. We showed that, in living zebrafish larvae, radiation could induce acute cerebral capillary shrinkage and blood-flow obstruction, resulting brain hypoxia and glycolysis retardant. Although in vivo neuron damage was also observed after the radiation exposure, further investigation found that they didn't response to the same dosage of radiation in vitro, indicating that radiation induced neuron damage was a secondary-effect of cerebral vascular function damage. In addition, transgenic labeling and qPCR results showed that the radiation-induced acute cerebral endothelial damage was correlated with intensive endothelial autophagy. Different autophagy inhibitors could significantly alleviate the radiation-induced cerebral capillary damage and prolong the survival of zebrafish larvae. Therefore, we showed that radiation could directly damage cerebral capillary, resulting to blood flow deficiency and neuron death, which suggested endothelial autophagy as a potential target for radiation-induced brain toxicity.

4.
J Am Heart Assoc ; 9(2): e014398, 2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31928173

RESUMO

Background A straight line-based model is often used to calculate the distance between an out-of-hospital cardiac arrest (OHCA) and the location of an automated external defibrillator (AED). This model may be inaccurate as it overlooks any obstacles between the OHCA and AED. This study aimed to elucidate the effect of the straight line-based and walking route-based calculation on the average distance between an historical OHCA and the closest AED and the coverage rate of AEDs, ie, the proportion of historical OHCAs that were within 100 meters of an AED. It is hoped that the findings will help policy makers in deploying AEDs in optimal urban settings. Methods and Results This was an observational study conducted in Hong Kong. The average distance between an historical OHCA and its closest AED and the coverage rate of AEDs were calculated with both the straight line-based and walking route-based model. A total of 1637 AEDs and 5119 cases of OHCA were included for analysis. The average distances calculated by the straight line-based and walking route-based model were 230.8 and 545.3 meters, respectively. The coverage rate calculated by the straight line-based model was 30.04%, while that by the walking route-based model was 11.17%. Conclusions The straight line-based model may underestimate the average distances and overestimate the coverage rate in an urban setting. The walking route-based model may be more useful for studies of AED deployment in urban cities.

5.
Graefes Arch Clin Exp Ophthalmol ; 258(2): 437-444, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31732811

RESUMO

PURPOSE: This study aims to describe the variation and characteristics of vessel density (VD) of the macula and optic disc in the normal eyes of children. METHODS: This was a retrospective study where subjects aged 5-18 years with normal eyes were enrolled. The macula and optic disc were scanned by optical coherence tomography angiography (OCTA). The influences of age, gender, and axial length (AL) on VD were analyzed. RESULTS: A total of 71 normal eyes from 71 subjects were enrolled. For the macula, the mean VD of fovea, parafovea, and perifovea at superficial retina and deep retina were 20.1%, 50.2%, 49.4%, 36.1%, 53.9%, and 48.1%, respectively. The mean foveal avascular zone (FAZ) was 0.277 mm2. For optic disc, the mean VD of radial peripapillary capillary (RPC) and inside-disc areas were 51.8% and 51.7%, respectively. Significant differences were found between the superior-hemi and inferior-hemi VD of the superficial retinal parafovea, deep retinal perifovea, and perifovea. The fovea VD of the superficial and deep retina and FAZ areas were different between genders. The inside-disc VD was positively correlated with AL, while other VDs had no significant correlation with age and AL. CONCLUSIONS: The parafovea VD of the superficial retina, parafovea, and perifovea of the deep retina had superior-hemi VD; boys had a higher fovea VD and smaller FAZ area than those of girls, the macular VD and peripapillary RPC density were steady for 5-18 year-olds. This study provided useful information for furthering the understanding of the development mode of vessel in children and the OCTA clinical applications in children.

6.
J Glob Health ; 9(2): 020436, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31788231

RESUMO

Background: To evaluate the disease burden of glaucoma in terms of disability-adjusted life years (DALY) and assess the contribution of risk factors to DALY due to glaucoma. Methods: Global, regional, and country DALY number, rate, and age-standardized rates of glaucoma were obtained from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI), Inequality-Adjusted HDI, Socio-Demographic Index (SDI), and other country-level data were derived from international open databases. Regression analysis was used to assess the correlations between the age-standardized DALY rate and the variables. Results: The global DALY due to glaucoma increased by 81% from 1990 to 2017 and decreased by 10% over the last two decades after adjusting for age and population size. Males had higher age-standardized DALY rates (P < 0.001). The age-standardized DALY rate was higher in countries with lower income or lower SDI (P < 0.001). The country-level age-standardized DALY rates in 2017 were negatively associated with HDI, SDI, country-level age-standardized prevalence rates of cataracts, cataract surgery rates (CRS), physician rates, and Inequality-Adjusted HDI. Stepwise multiple regressions showed that HDI, CRS, and Inequality-Adjusted HDI were significantly negatively associated with the country-level age-standardized DALY rate in 2017 after adjusting for other confounding factors (P < 0.001). Conclusions: Higher education, higher CRS, and diminishing the inequality in resource distribution may help reduce the disease burden of glaucoma. These findings can provide information for policymakers and could serve as an impetus for efforts toward alleviating the disease burden of glaucoma.


Assuntos
Glaucoma/epidemiologia , Saúde Global/tendências , Idoso , Idoso de 80 Anos ou mais , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco
7.
Chem Commun (Camb) ; 56(2): 245-248, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31803872

RESUMO

The capacity degradation mechanism of a spent LiFePO4 (LFP) cathode was investigated systematically and the occurrence of FePO4 in the cathode due to loss of Li+ was found to be mainly responsible for the short cycle life of LFP batteries. Given this, an easy, low-cost, and green cathode regeneration method was proposed. This work provides a new perspective for the recycling of spent batteries.

8.
Biol Res Nurs ; : 1099800419894641, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31867989

RESUMO

PURPOSE: Patients with Type 2 diabetes (T2D) have increased risk of depression and anxiety. Evidence suggests that a heightened inflammatory state may contribute to this association. Females experience more depression and higher inflammation levels than males. This study compared associations of serum high-sensitivity C-reactive protein (hs-CRP) levels with symptoms of depression and anxiety between men and women with Type 2 diabetes mellitus (T2DM). METHOD: Cross-sectional data including demographic and disease characteristics, symptoms of depression and anxiety, clinical data, and laboratory values were collected from 392 patients with T2DM recruited from a general hospital in Shandong Province, China. We evaluated associations between serum hs-CRP level and symptoms of depression and anxiety in males and females separately using multiple linear regressions and χ2 tests for trend. RESULTS: Sex moderated the association between serum hs-CRP level and symptoms of depression (B = .112 [SE = 0.049]; p = .022) and anxiety (B = .137 [SE = 0.053]; p = .011). Among females, hs-CRP level was positively associated with depression (B = .034, 95% confidence interval [CI] = [.006, .061]; p = .016, false discovery rate [FDR]-adjusted p = .020) and anxiety (B = .041, 95% CI [.011, .071], p = .007, FDR-adjusted p = .007). Positive trends indicated a higher prevalence of clinically significant symptoms of depression and anxiety in higher serum hs-CRP categories in females. No associations were found in males. CONCLUSION: Findings demonstrate that associations between serum hs-CRP level and symptoms of depression and anxiety in patients with T2D are sex-specific, with only females demonstrating a significant positive association.

9.
Opt Express ; 27(22): 32047-32057, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31684424

RESUMO

The gamma effect of phase-measuring profilometry systems yields nonlinear errors, which will substantially reduce the 3D shape measurement accuracy. Here, a robust and flexible gamma correction method based on the probability distribution function (PDF) of the wrapped phase is presented. First, a series of PDF curves are generated from the simulated wrapped phase distributions with different gamma values. Second, an experimental PDF curve will be produced after obtaining the wrapped phase from the captured three-step phase-shift fringe images. Then, a correlation procedure will be used to find the most similar PDF curve from the simulated PDF curves, and the gamma value of the matched PDF curve is that of the current system. Note that the gamma value detected by this method will be smaller than the true value due to the defocusing effect of the projection system with a large aperture. Therefore, an improved PDF-based algorithm, which projects two sets of three-step phase-shifting sinusoidal fringe patterns with different pre-coded gamma values and produces two PDF curves, is also added. Then after one more correlation procedure, a more accurate systematic gamma value could be calculated. It does not need large-step phase-shift images and 2×3 fringe images are quite enough. The experimental results show that the technique is very fast, easy to use and quite accurate.

10.
Front Oncol ; 9: 1116, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31696059

RESUMO

Purpose: Our study aimed to provide data on effectiveness, safety of crizotinib treatment, brain metastases, progression patterns, and sequential therapy beyond crizotinib treatment in patients with advanced ALK-positive NSCLC in China. Methods: We reviewed the medical records of crizotinib-treated NSCLC patients with ALK-rearrangement between May 2014 and May 2018 at Fudan University Shanghai Cancer Center. All patients received crizotinib with 250 mg twice daily. Main outcome measures were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), the second PFS (PFS2), overall survival (OS), and adverse events. Results: One hundred and four patients with ALK-positive NSCLC were included in this retrospective study. ORR and DCR were 82.7 and 98.1%, respectively. The estimated PFS and OS were 13.0 months (95% CI 9.0-17.0 months) and 36.0 months (95% CI 31.0-41.0 months), respectively. Multivariable analysis showed that young age, presence of baseline adrenal gland metastases and non-adenocarcinoma were independent predictive factors for poorer PFS. Presence of baseline adrenal gland metastases, non-adenocarcinoma, intrathoracic progression and shorter crizotinib treatment time were associated with worse OS. Patients without baseline brain metastases (BBM) who were administered with crizotinib as first-line therapy can achieve a significantly longer PFS than those who received crizotinib as second or later line therapy (p = 0.006). For patients with BBM receiving sequential therapy beyond the first disease progression after crizotinib treatment (1st PD), crizotinib beyond progressive disease (CBPD) plus local therapy can lead to a significantly longer PFS2 (67.0 vs. 21.0 weeks; p = 0.046). Additionally, the OS was significantly longer in patients achieving 1st PD who received CBPD plus local therapy than those who did not receive CBPD or local therapy (35.0 vs. 24.0 months, p = 0.041). Presence of brain metastases at any time was in association with worse PFS. No unexpected adverse effects were reported. Conclusions: Crizotinib was effective and well tolerated in Chinese patients with ALK-positive, advanced NSCLC in real-world clinical practice. For patients without BBM, crizotinib as first-line therapy can lead to a longer PFS than second-or later line therapy. CBPD plus local therapy after 1st PD beyond crizotinib is feasible and effective in clinical routine practice.

11.
Ann Transl Med ; 7(18): 477, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31700913

RESUMO

Background: The interaction between platelets and macrophages plays an important role in the development and progression of atherosclerosis (AS). This study aimed to investigate the role of platelet microparticles (PMPs) in the development of foam cells. Methods: PMPs are generated by activating platelets with thrombin and separated by ultracentrifugation. The macrophages were treated with PMPs, the phagocytosis of oxidized low-density lipoprotein (Ox-LDL) and formation of foam cells were evaluated by flow cytometry and confocal microscopy, respectively, and the inflammatory factors cytokines in the supernatant were detected by ELISA. Results: PMPs significantly increase the phagocytosis of Ox-LDL and elevated foam cell formation of macrophages. IL-1ß content in the supernatant of macrophages peaked around 2-4 h and declined to normal level after 6-8 h; IL-6 content peaked at 4 h and then decreased to normal level. TNF-α content peaked at 2-4 h. Conclusions: The microparticles from activated platelets can increase the phagocytosis of Ox-LDL and the production of inflammatory cytokines by macrophages, which is related to the development of AS.

12.
Int J Oncol ; 55(6): 1385-1395, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31638200

RESUMO

Eukaryotic initiation factor 3c (eIF3C) is involved in the initiation of protein translation. Aberrant eIF3C expression has been reported in different types of human cancer. The present study aimed to assess the role of eIF3C in the malignant behavior of renal cell carcinoma in vitro and in vivo. eIF3C expression was assessed in 16 pairs of renal cell carcinoma (RCC) and matched distant normal tissues, and in RCC cell lines using immunohistochemistry. Subsequently, eIF3C was depleted using lentiviral short hairpin RNA and cell proliferation, cell cycle distribution and apoptosis of these eIF3C­depleted cells were examined. Additionally, tumor cell xenograft assays in nude mice, Affymetrix microarrays and ingenuity pathway analyses were performed. eIF3C expression was upregulated in RCC tissues and cell lines. Depletion of eIF3C reduced tumor cell proliferation and arrested them at the G1 stage, thus promoting their apoptosis in vitro. Depletion of eIF3C also inhibited the formation and growth of tumor cell xenografts in nude mice. In addition, depletion of eIF3C altered the expression levels of 994 differentially expressed genes in RCC cells (516 genes were upregulated and 478 genes were downregulated). The expression levels of phosphorylated­AKT, c­JUN and NFKB inhibitor α were lower in the shorth hairpin RNA eIF3C­transfected RCC cells compared with in the control group. In conclusion, the present study demonstrated that upregulated eIF3C expression contributed to the development and progression of RCC. Future studies should further evaluate whether eIF3C could be used as a potential strategy for RCC targeting therapy.

13.
Genet Test Mol Biomarkers ; 23(11): 791-796, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31644309

RESUMO

Objective: The purpose of this study was to investigate associations between the 14 reported loci (from a meta-analysis of genome-wide association studies [GWAS] in the Caucasian population) and vitiligo in the Chinese Han population. Materials and Methods: In this study 14 single nucleotide polymorphisms (SNPs) at 14 different genetic loci were evaluated for their association with viteligo in a Chinese Han cohort, including 1472 cases and 1472 controls of by using the Sequenom MassArray iPLEX1 system. A Bonferroni adjustment was used for multiple comparisons and pBonferroni <0.0056 was considered statistically significant. Results: The T allele of the locus within the FBXO45-NRROS gene (3q29) was significantly associated with vitiligo (odds ratio = 1.22, 95% confidence interval: 1.10-1.36, p = 0.0001). Association at the genotype level was strong (p = 0.0007). The other SNPs were not associated with vitiligo (pBonferroni >0.0056). Conclusion: A SNP at the rs6583331 locus 3q29 is associated with the susceptibility of vitiligo in the Chinese Han population, which suggests that there is a common genetic factor predisposing to the development of vitiligo in the Chinese and Caucasian populations.

14.
J Zhejiang Univ Sci B ; 20(11): 910-919, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31595727

RESUMO

OBJECTIVE: Mental disorders of the elderly population in China deserve attention. Social health is significantly associated with depression. This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults. METHODS: We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province, China. Face-to-face interviews were used to complete a structured questionnaire for all participants. We used the Social Health Scale for the Elderly (SHSE) to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms. Multivariate logistic regression was used to evaluate the association between social health status and depressive symptoms. RESULTS: Of the total of 3757 participants included, 1887 (50.23%) were female, and the mean±standard deviation (SD) age was (70.0±8.3) years. The rate of depressive symptoms was 25.92%. The social health score was higher in non-depressed participants than in depressed participants (raw score 50.7 vs. 48.3, P<0.001). Participants with "moderate" or "good" social health had a significantly lower risk of depressive symptoms than those with "poor" social health (odds ratio (OR)=0.55, 95% confidence interval (CI): 0.46-0.66 for moderate social health; OR=0.45, 95% CI: 0.35-0.60 for good social health). The association between social health and depressive symptoms was consistent across several subgroups. CONCLUSIONS: Social health is significantly inversely associated with depressive symptoms. The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits, but systematic assessment to guide intervention merits further investigation.

16.
Cancer Epidemiol Biomarkers Prev ; 28(12): 2014-2021, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31562207

RESUMO

BACKGROUND: To explore the relationship between family history of esophageal cancer, SNPs, and the risk of esophageal squamous cell carcinoma (ESCC), we performed a population-based case-control study and developed a genetic family history-related risk (GFR) score and non-family history-related risk (GnFR) score to quantify the cumulative number of risk genotypes carried by each individual. METHODS: We used data of 700 patients with nonfamilial ESCC, 341 patients with familial ESCC, 1,445 controls without a family history of esophageal cancer, and 319 controls with a family history. We genotyped 87 genetic variants associated with the risk for ESCC, and constructed GFR and GnFR scores for cases and controls. RESULTS: Our results show that ESCC risk increased with higher GFR score (P trend = 0.0096). Among the familial subgroup, we observed a nearly 7-fold [95% confidence interval (CI), 1.92-24.77] higher risk of ESCC in the highest GFR score group. The corresponding estimate was only 2-fold (95% CI, 1.41-3.93) higher risk of ESCC, in the stratum without a reported family history of esophageal cancer. Certain cell signaling pathways and immune-related pathways were enriched, specifically in familial ESCC. Results from a reconstructed cohort analysis demonstrated that cumulative risk to get esophageal cancer by age 75 years was 13.3%, 10.2%, 8.2%, and 5.1%, respectively, in four subgroups as defined by first-degree relatives of cases or controls with high or low genetic risk score. In particular, the cohort of relatives of ESCC cases with low genetic risk score exhibit a higher cumulative risk than the cohort of relatives of controls with high genetic risk score. It demonstrates that environmental factors play a major role in esophageal cancer. CONCLUSIONS: Further studies are warranted to dissect the mechanisms of shared environmental and genetic susceptibility affecting the risk of getting ESCC. IMPACT: Our study highlights that the need of preventive strategies to screen certain genetic polymorphisms, especially in individuals whose relatives had ESCC.

17.
Technol Cancer Res Treat ; 18: 1533033819875136, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31526114

RESUMO

PURPOSE: To analyze the correlation of hepatitis B virus reactivation with patient-related and treatment-related dose-volume factors and to describe the feasibility of hepatitis B virus reactivation analyzed by a normal tissue complication probability model for patients with hepatocellular carcinoma treated with radiotherapy. MATERIALS AND METHODS: Ninety patients with hepatitis B virus-related hepatocellular carcinoma treated with radiotherapy were enrolled in this retrospective study and were followed from June 2009 to December 2015. Of the 90 patients, 78 had received conventional fractionation radiotherapy to a mean dose of 39.6 to 50.4 Gy and 12 patients were scheduled to receive hypofractionation. The physical doses were converted into 2 Gy equivalents for analysis. The parameters, TD50 (1), n, and m, of the Lyman-Kutcher-Burman normal tissue complication probability model were derived using maximum likelihood estimation. Bootstrap and leave-one-out were employed to against model overfitting and improve the model stability. RESULTS: Radiation-induced liver diseases were 17.8%, hepatitis B virus reactivation was 22.2%, and hepatitis B virus reactivation-induced hepatitis was 21.1%, respectively. In multivariate analysis, the V 5Gy was associated with hepatitis B virus reactivation; TD50 (1), m, and n were 32.3, 0.55, and 0.71 Gy, respectively, for hepatitis B virus reactivation. Bootstrap and leave-one-out results showed that the hepatitis B virus parameter fits were extremely robust. CONCLUSION: A Lyman-Kutcher-Burman normal tissue complication probability model has been established to predict hepatitis B virus reactivation for patients with hepatocellular carcinoma who received radiotherapy.

18.
Clin Lung Cancer ; 20(6): e638-e651, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31375452

RESUMO

BACKGROUND: The purpose of the study was to investigate the potential of a radiomic signature developed in a general non-small-cell lung cancer (NSCLC) cohort for predicting the overall survival of anaplastic lymphoma kinase (ALK)-positive (ALK+) patients with different treatment types. MATERIALS AND METHODS: After test-retest in the Reference Image Database to Evaluate Therapy Response data set, 132 features (intraclass correlation coefficient > 0.9) were selected in the least absolute shrinkage and selection operator Cox regression model with a leave-one-out cross-validation. The NSCLC radiomics collection from The Cancer Imaging Archive was randomly divided into a training set (n = 254) and a validation set (n = 63) to develop a general radiomic signature for NSCLC. In our ALK+ set, 35 patients received targeted therapy and 19 patients received nontargeted therapy. The developed signature was tested later in this ALK+ set. Performance of the signature was evaluated with the concordance index (C-index) and stratification analysis. RESULTS: The general signature had good performance (C-index > 0.6; log rank P < .05) in the NSCLC radiomics collection. It includes 5 features: Geom_va_ratio, W_GLCM_Std, W_GLCM_DV, W_GLCM_IM2, and W_his_mean. Its accuracy of predicting overall survival in the ALK+ set achieved 0.649 (95% confidence interval [CI], 0.640-0.658). Nonetheless, impaired performance was observed in the targeted therapy group (C-index = 0.573; 95% CI, 0.556-0.589) whereas significantly improved performance was observed in the nontargeted therapy group (C-index = 0.832; 95% CI, 0.832-0.852). Stratification analysis also showed that the general signature could only identify high- and low-risk patients in the nontargeted therapy group (log rank P = .00028). CONCLUSION: This preliminary study suggests that the applicability of a general signature to ALK+ patients is limited. The general radiomic signature seems to be only applicable to ALK+ patients who had received nontargeted therapy, which indicates that developing special radiomics signatures for patients treated with tyrosine kinase inhibitors might be necessary.

19.
Thorac Cancer ; 10(8): 1725-1735, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31293066

RESUMO

BACKGROUND: Lower thoracic esophageal cancer (LTEC) with celiac node metastasis and upper thoracic esophageal cancer (UTEC) with supraclavicular node metastasis were previously categorized as M1a diseases. Our study aimed to investigate whether the clinical significance of supraclavicular and celiac lymph node metastasis should be reevaluated in thoracic esophageal cancer. METHODS: A total of 6178 patients with thoracic esophageal cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database during 2004-2015. Treatment strategies and outcomes (OS, overall survival; CSS, cancer-specific survival) of patients with different nodal status were reviewed. The Cox proportional hazards regression model was applied to evaluate the prognostic factors. Statistical analyses were performed in all subgroups. RESULTS: Multivariate analysis identified supraclavicular node metastasis but not celiac node metastasis as an independent predictor of both OS and CSS in LTEC. However, metastasis to supraclavicular or celiac nodes was not an independent predictor of OS and CSS in UTEC. Surgery was not associated with increased OS and CSS for UTEC with celiac or supraclavicular node metastasis but was favored as a predictor of better OS and CSS for LTEC with celiac or supraclavicular node metastasis. Radiotherapy benefited OS and CSS in LTEC involving celiac or supraclavicular nodes and in UTEC involving celiac nodes, while only OS benefited from radiotherapy in UTEC involving supraclavicular nodes. CONCLUSIONS: These results provide preliminary evidence that the clinical significance of supraclavicular and celiac lymph node metastasis should be reevaluated in thoracic esophageal cancer with different prognostic information according to the primary sites.

20.
Neuroendocrinology ; 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31357196

RESUMO

BACKGROUND: Significant modifications have been made in the eighth edition of the American Joint Committee on Cancer (AJCC) distant metastases (M) stage classification for metastatic pancreatic neuroendocrine tumors (Pan-NET). We aimed to validate this revised classification among metastatic Pan-NET patients using the Surveillance, Epidemiology, and End Results (SEER) database. We further sought to evaluate the feasibility of applying this classification to metastatic pancreatic neuroendocrine carcinoma (Pan-NEC) and pancreatic ductal adenocarcinoma (PDAC) patients. METHODS: Stage IV pancreatic neuroendocrine neoplasm (Pan-NEN, including G1/G2 Pan-NET, G3 Pan-NEC classified according to the WHO 2010 grading scheme) and PDAC patients with metastatic disease diagnosed between 2010 and 2015 were identified and restaged according to the revised M stage classification for Pan-NET. Overall survival (OS) was compared using the Kaplan-Meier analysis and log-rank test. Univariate and multivariate Cox regression models were utilized to identify prognostic factors. RESULTS: A total of 1371 stage IV Pan-NEN and 634 PDAC patients were included. Among Pan-NEN patients, liver (75.0%) was the most common metastatic site, followed by distant lymph node (8.5%), lung (8.4%), bone (7.3%) and brain (1.0%). The 5-year OS for Pan-NET patients with M1a, M1b and M1c stage were 44.15%, 53.32% and 19.70%, respectively. However, a survival comparison showed no significant difference between M1a and M1b stages among Pan-NET patients. Similar findings were noted after applying this classification to Pan-NEC patients. Multivariate analysis showed that the age at diagnosis and the number of distant metastatic sites were independent prognostic factors for metastatic Pan-NEN patients. Interestingly, excellent survival discrimination by M stage among stage IV PDAC patients was noted (M1a vs. M1b vs. M1c, 5-year OS: 5.42%, 2.46% and 0, respectively). CONCLUSION: Our study is the first large-sample size based validation of the AJCC 8th M stage classification for Pan-NET. The revised classification did not effectively stratify metastatic Pan-NEN patients. However, further study is warranted to validate this classification for Pan-NET patients according to the WHO 2017 classification. Interestingly, the revised M stage classification might be feasible for PDAC patients with metastatic disease.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA