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1.
Medicine (Baltimore) ; 99(1): e18489, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895782

RESUMO

BACKGROUND: In a multitude of previous studies, Chlamydia trachomatis (CT) plays an important role in the occurrence of ectopic pregnancy (EP). However, the predictive value of CT infections in the occurrence of EP has not been estimated worldwide. We thus evaluated, by means of a meta-analysis, the current status of the association between CT infections with EP and the potential predictive value of CT infections in EP. METHODS: We evaluated studies performed between the database construction time and August 2018 published in PubMed, the Cochrane Library, EMBASE, and the Web of Science (SCI). The relationship between CT and EP was calculated based upon the predetermined entry criteria for control group selection and the original data. The related articles were analyzed using a random-effects model, and the heterogeneity of the studies was assessed using the I index. Data were analyzed with the STATA 12.0 software. RESULTS: Twenty-five studies that recruited 11960 patients were included in the present meta-analysis, and the relation of CT infections with EP were assessed. The association between CT infections and EP risk showed an odds ratio (OR) of 3.03, with a 95% confidence interval (CI) of 2.37 to 3.89. Our results showed that there was a statistically significant difference between the intervention and control groups. The prevalence of CT infections in EP was then calculated by a subgroup analysis: African (OR, 2.22; 95% CI, 1.14-4.31), European (OR, 3.16; 95% CI, 2.10-4.47), North American (OR, 3.07; 95% CI, 1.78-5.31), and Asian (OR, 3.39; 95% CI, 1.95-5.90). CONCLUSIONS: From the results of numerous studies conducted on different continents, this meta-analysis showed a clear association between EP and prior CT infections, that is, CT infections increase the risk of EP occurrence.


Assuntos
Infecções por Chlamydia/epidemiologia , Gravidez Ectópica/epidemiologia , Adulto , Chlamydia trachomatis , Feminino , Humanos , Razão de Chances , Gravidez , Gravidez Ectópica/etiologia , Prevalência , Fatores de Risco , Sensibilidade e Especificidade
2.
Libyan J Med ; 14(1): 1652058, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31405338

RESUMO

Objective: To investigate the effect of the duration of gonadotropin releasing hormone agonist (GnRH-a) use on the outcome of in vitro fertilization and embryo transfer (IVF-ET) during the short-acting long-term hyperstimulation cycle. Methodology: Clinical data from 776 patients receiving controlled ovarian stimulation (COS) after short-term regimen downregulation were retrospectively analyzed. According to the duration of GnRH-a, the patients were divided into 3 groups: Group A, 14 days for GnRH-a; Group B, 15-17 days for GnRH-a; and Group C, >18 days for GnRH-a. The clinical data, treatment and clinical outcomes were compared among the groups. Results: There were no significant differences in fertilization rate, implantation rate, clinical pregnancy rate, abortion rate, ovarian hyperstimulation syndrome (OHSS) rate(P > 0.05). The total costs in group A were significantly less than those in group B and C(P < 0.001). The number of eggs and quality embryos generated in group A was significantly higher than that in groups B and C (P = 0.014, P = 0.005). Conclusions: In the short-acting GnRH agonist long protocol, satisfactory IVF-ET pregnancy outcome was obtained with the use of GnRH-a for 14 days under the premise of lowering the receptor-regulating standard. Excessive application of GnRH-a will affect the number of eggs and embryos and increase the cost of medical treatment.

3.
Oncotarget ; 7(35): 56193-56199, 2016 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-27486880

RESUMO

BACKGROUND: The expression levels and clinical significances of Lysosomal-associated protein transmembrane-4ß-35 (LAPTM4B-35) protein are unknown in the non-small-cell lung cancer (NSCLC). This study aimed to explore the expression and prognostic value of LAPTM4B-35 in NSCLC patients. METHODS: The clinicopathological and survival data of 107 NSCLC patients who received radical surgery from 2007 and 2011 were reviewed. The LAPTM4B-35 expression of the paired tumors and adjacent normal specimens were detected, and the association between LAPTM4B-35 and clinical variables was explored. Kaplan-Meier analysis and Cox regression (Proportional hazard model) were performed to investigate the prognostic significance for NSCLC. RESULTS: LAPTM4B-35 was over expressed in NSCLC tissues. The elevated LAPTM4B-35 expression was associated with cancer recurrence (P = 0.031). The 5-year median OS and PFS were significantly worse in the LAPTM4B-35 overexpressed group. Multivariate Cox analysis showed that LAPTM4B-35 over-expression was an independent factor for OS and PFS in NSCLC(P = 0.018, P = 0.026, respectively). CONCLUSIONS: The overexpressed LAPTM4B-35 was an independent prognostic biomarker for NSCLC, which could predict cancer recurrence and poor over survival. And that may be applied as potential target for NSCLC treatment.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Pulmonares/genética , Proteínas de Membrana/metabolismo , Recidiva Local de Neoplasia/genética , Proteínas Oncogênicas/metabolismo , Idoso , Biomarcadores Tumorais/metabolismo , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Fatores de Risco
4.
Oncotarget ; 7(34): 55765-55770, 2016 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-27303917

RESUMO

BACKGROUNDS: High serum C-reactive protein (CRP) was found to be associated with poor prognosis in kinds of solid tumors, however, its role in the recurrent gastric cancer (RGC) is unknown. The present study aimed to explore the prognostic value of serum CRP in RGC patients. METHODS: A total 72 RGC patients who underwent radical surgery from January 2005 to May 2008 were enrolled. The clinical, pathological and survival information were collected. The serum CRP level was measured when the recurrence was confirmed, and the association between serum CRP and clinicopathological characters was analyzed. The prognostic value of serum CRP for RGC was investigated. RESULTS: The serum CRP was elevated in 39 patients (H-CRP), while 33 patients were within the normal range (N-CRP).The elevated CRP was associated with Lymph node metastasis (p = 0.003) and tumor size (p = 0.004). The median survival time after recurrence was significantly worse in the H-CRP group than N-CRP group (6.5 months vs. 11.5 months, p = 0.012). Multivariate analyses identified that elevated CRP level (HR=2.325, p < 0.001), time to recurrence (HR = 0.466, p=0.033), and the follow-up treatment (HR = 2.650, p=0.001) were independent prognostic factors. CONCLUSIONS: High serum CRP level was associated with aggressive pathological features, was an independent poor prognostic factors for RGC, which might be a potential prognostic marker for RGC patients.


Assuntos
Proteína C-Reativa/análise , Recidiva Local de Neoplasia/mortalidade , Neoplasias Gástricas/mortalidade , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/patologia , Prognóstico , Modelos de Riscos Proporcionais , Neoplasias Gástricas/sangue , Neoplasias Gástricas/patologia
5.
Tumour Biol ; 37(1): 503-10, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26227221

RESUMO

G protein-coupled receptor, family C, group 5, member A (GPRC5A) had received attentions for its role in carcinogenesis and prognostic values in several types of cancer. However, the functional roles of GPRC5A in gastric cancer (GC) had never been elucidated. The expression levels of GPRC5A were detected by real-time quantitative reverse transcription PCR and Western blot in GC tissues and adjacent non-tumor tissues. GPRC5A expression in tissue sections of 106 GC samples was evaluated using immunohistochemistry. The staining results were compared with clinicopathological factors and to the prognosis of GC patients. The mRNA and protein expression levels of GPRC5A in gastric cancer tissues were higher than those in adjacent non-tumor tissues. Positive GPRC5A expression was significantly correlated with larger size of primary tumor, diffuse type (Lauren's classification), deeper serosal invasion, and more lymph node metastasis. In addition, Kaplan-Meier curve analysis demonstrated that GC patients with positive GPRC5A expression had poor prognosis than those with negative GPRC5A expression. GPRC5A expression was identified as an independent factor of the overall survival in GC patients by multivariate Cox analysis. Further, the overall survival difference existed between patients with GPRC5A positive and negative groups in GC patients with lymph node metastasis. Our results suggested that elevated levels of GPRC5A played significant roles in GC progression. GPRC5A could serve as a prognostic biomarker of GC.


Assuntos
Regulação Neoplásica da Expressão Gênica , Receptores Acoplados a Proteínas-G/metabolismo , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/metabolismo , Idoso , Biomarcadores Tumorais/metabolismo , Feminino , Perfilação da Expressão Gênica , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Resultado do Tratamento
6.
J Am Coll Surg ; 221(2): 579-90, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26077602

RESUMO

BACKGROUND: The aim of this study was to investigate the messenger RNA and protein expressions of SET and MYND domain-containing protein 3 (SMYD3) and transforming growth factor-ß1 (TGF-ß1) in gastric cancer (GC) and to explore the correlations between these proteins and the biologic behavior of GC. STUDY DESIGN: Expressions of SMYD3 and TGF-ß1 were detected by real-time quantitative reverse transcription polymerase chain reaction and Western blot in GC tissues and adjacent nontumor tissues. In addition, SMYD3 and TGF-ß1 expressions were analyzed by immunohistochemistry in formalin-fixed samples from 166 GC patients. RESULTS: The messenger RNA and protein expression levels of SMYD3 and TGF-ß1 in GC tissues were significantly higher than those in adjacent nontumor tissues. A significantly positive correlation was found between SMYD3 expression and TGF-ß1 expression in GC tissues. In addition, the size of the primary tumor and lymph node metastasis were identified as the independently relative factors of SMYD3 expression in GC tissues, and lymph node metastasis was identified as the independently relative factor of TGF-ß1 expression. Multivariate analysis demonstrated that the degree of differentiation, serosal invasion, lymph node metastasis, SMYD3 expression, and TGF-ß1 expression were the independent prognostic indicators for GC. Transforming growth factor-ß1 expression was one of the optimal prognostic predictors of patients identified using the Cox regression with Akaike Information Criterion value calculation. CONCLUSIONS: SET and MYND domain-containing protein 3 expression and TGF-ß1 expression in GC tissues were significantly and positively correlated. High expression levels of SMYD3 and TGF-ß1 can indicate poor prognoses for GC patients.


Assuntos
Adenocarcinoma/metabolismo , Biomarcadores Tumorais/metabolismo , Histona-Lisina N-Metiltransferase/metabolismo , Neoplasias Gástricas/metabolismo , Fator de Crescimento Transformador beta1/metabolismo , Adenocarcinoma/mortalidade , Adulto , Idoso , Western Blotting , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Reação em Cadeia da Polimerase em Tempo Real , Neoplasias Gástricas/mortalidade , Análise de Sobrevida , Regulação para Cima
7.
Tumour Biol ; 36(10): 8101-6, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25983003

RESUMO

Metformin has been reported having potential anticancer effect on kinds of solid tumors, but its role in combined small-cell lung cancer (C-SCLC) remains indistinct. This study aimed to explore whether metformin use has a prognosis benefit in diabetic C-SCLC patients. A total of 259 C-SCLC patients with diabetes were enrolled in our study. The clinicopathological parameters and survival data were collected and analyzed. The correlation between metformin use and clinicopathological characters was analyzed. Univariate and multivariate analyses were performed to investigate the prognostic significance of metformin use for C-SCLC. The metformin was used in 120 (46.3 %) patients. Our data showed that the metformin use decreased C-SCLC recurrence rate (p = 0.001). The median overall survival (OS) and disease-free survival (DFS) were significantly better in the metformin use group compared to non-metformin group (OS 19.0 vs 11.5 months, p < 0.001; DFS 10.5 vs 7.0 months, p < 0.001). Multivariate analyses indicated that metformin use was an independent prognostic factor for OS and DFS (p = 0.001 vs p = 0.018). The metformin use improved the long-term outcome of C-SCLC patients with diabetes, which might be considered a potential useful prognostic indicator and anticancer drug.


Assuntos
Diabetes Mellitus/mortalidade , Hipoglicemiantes/uso terapêutico , Neoplasias Pulmonares/mortalidade , Metformina/uso terapêutico , Recidiva Local de Neoplasia/mortalidade , Carcinoma de Pequenas Células do Pulmão/mortalidade , Idoso , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/patologia , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Masculino , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/patologia , Taxa de Sobrevida
8.
Tumour Biol ; 36(6): 4377-86, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25627005

RESUMO

SET and MYND domain-containing protein 3 (SMYD3) plays a key role in the progression of human cancer. Matrix metalloproteinase (MMP)-9 is being related to tumor progression. It has been reported that SMYD3 and MMP-9 are overexpressed in human cancers. However, the exact roles of SMYD3 and MMP-9 in the metastasis and prognosis of gastric cancer (GC) remain unclear. The expressions of SMYD3 and MMP-9 were detected by semiquantitative reverse transcription polymerase chain reaction and Western blotting in gastric cancer and adjacent nontumor tissues. In addition, SMYD3 and MMP-9 expressions were analyzed by immunohistochemistry in formalin-fixed samples from 186 gastric cancer patients. The messenger RNA (mRNA) and protein expression levels of SMYD3 and MMP-9 in gastric cancer tissues were both significantly higher than those in adjacent nontumor tissues. In addition, the expression of SMYD3 was correlated with size of primary tumor and lymph node metastasis, while size of primary tumor and serosal invasion were identified as the independently relative factors of MMP-9 expression in GC tissues. SMYD3 expression and MMP-9 expression in GC tissues were significantly and positively correlated. Multivariate analysis results demonstrated that degree of differentiation, lymph node metastasis, TNM stage, SMYD3 expression, and MMP-9 expression were the independent prognostic indicators of gastric cancer. SMYD3 and MMP-9 may play important roles in tumor invasion, metastasis, and prognosis and could work as promising targets for prognostic prediction in gastric cancer.


Assuntos
Histona-Lisina N-Metiltransferase/biossíntese , Metaloproteinase 9 da Matriz/biossíntese , Prognóstico , Neoplasias Gástricas/genética , Adulto , Idoso , Feminino , Regulação Neoplásica da Expressão Gênica , Histona-Lisina N-Metiltransferase/genética , Humanos , Estimativa de Kaplan-Meier , Masculino , Metaloproteinase 9 da Matriz/genética , Pessoa de Meia-Idade , Invasividade Neoplásica/genética , Metástase Neoplásica , Estadiamento de Neoplasias , RNA Mensageiro/biossíntese , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/patologia
9.
Ann Surg Oncol ; 22(2): 565-72, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25155400

RESUMO

BACKGROUND: It is still controversial whether tumor size (Ts) should be considered an important indicator for evaluation the prognosis of gastric cancer (GC). The purpose of this study was to elucidate the prognostic prediction superiority of Ts in the large-scale cohort of GC patients. METHODS: Data from 1,521 patients who underwent the curative resection were analyzed for demonstration the prognostic value of Ts. In addition, a tumor size-node-metastasis (TsNM) classification system was proposed to evaluate the comparative superiorities of the prognostic prediction of GC patients. RESULTS: With the univariate and multivariate analyses, Ts was identified as an independently prognostic predictor of GC patients, as was T stage. Ts was demonstrated to have smaller Akaike information criterion and Bayesian Information Criterion values within the Cox regression analyses than shown by T stage, which represented the optimum prognostic stratification. TsNM classification was also found to be competent for accurately prognostic evaluation of GC patients. The matched case-control logistic regression showed that TsNM classification could provide very powerful discriminations of patients' overall survival, compared with TNM classification. Additionally, Ts stage was found to enhance the survival discriminations in patients with certain clinicopathological characteristics, including male gender, T4a stage, N0 stage, diffuse type of Lauren classification, or age ≤60 years. CONCLUSIONS: Ts should be recommended as an important clinicopathologic variable to enhance the accuracy of the prognostic prediction of GC clinical patients.


Assuntos
Neoplasias Gástricas/cirurgia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Feminino , Gastrectomia , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Análise de Sobrevida , Adulto Jovem
10.
Zhonghua Wei Chang Wai Ke Za Zhi ; 17(10): 997-1001, 2014 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-25341907

RESUMO

OBJECTIVE: To explore the clinicopathological characteristics and prognosis of familial gastric cancer(FGC) and to provide clinical evidence for rational treatment program. METHODS: Clinicopathological data of 91 patients with FGC and 293 patients with sporadic gastric cancer(SGC) in our department from March 2003 to October 2007 were retrospectively analyzed and compared between the two groups. RESULTS: Tumors with a diameter of less than or equal to 5 cm were more common in FGC patients than SGC patients [65.9%(60/91) vs. 52.6%(154/293), P=0.025]. Proportion of FGC patients with poor differentiation was significantly higher as compared to SGC patients [68.1%(62/91) vs. 55.6%(163/293), P=0.034]. The 5-year overall survival rate in FGC patients was significantly lower than that in SGC patients(25.6% vs. 38.9%, P=0.001). Further stratified analysis revealed that the 5-year survival rates of T4 FGC and T4 SGC patients were 14.5% and 30.5% respectively, the 5-year survival rates of N3 FGC and N3 SGC patients were 10.4% and 17.3% respectively, and the differences were statistically significant(all P<0.05), while other T stage and N stage between the two groups were not significantly different(all P>0.05). Univarite analysis showed that tumor size, tumor location, pathological type, operation method, infiltration depth and lymph node metastasis were influencing factors of prognosis of FGC. Multivariate analysis showed that tumor size(HR=2.271), pathology types(HR=1.449), lymph node metastasis(HR=1.748) and the infiltration depth(HR=1.487) were independent risk factors affecting the prognosis of patients with FGC. CONCLUSION: Compared with SGC, FGC is associated with poor differentiation and poor prognosis.


Assuntos
Neoplasias Gástricas/patologia , Humanos , Metástase Linfática , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
11.
World J Gastroenterol ; 20(25): 8244-52, 2014 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-25009399

RESUMO

AIM: To elucidate the potential impact of the grade of complications on long-term survival of gastric cancer patients after curative surgery. METHODS: A total of 751 gastric cancer patients who underwent curative gastrectomy between January 2002 and December 2006 in our center were enrolled in this study. Patients were divided into four groups: no complications, Grade I, Grade II and Grade III complications, according to the following classification systems: T92 (Toronto 1992 or Clavien), Accordion Classification, and Revised Accordion Classification. Clinicopathological features were compared among the four groups and potential prognostic factors were analyzed. The Log-rank test was used to assess statistical differences between the groups. Independent prognostic factors were identified using the Cox proportional hazards regression model. Stratified analysis was used to investigate the impact of complications of each grade on survival. RESULTS: Significant differences were found among the four groups in age, sex, other diseases (including hypertension, diabetes and chronic obstructive pulmonary disease), body mass index (BMI), intraoperative blood loss, tumor location, extranodal metastasis, lymph node metastasis, tumor-node-metastasis (TNM) stage, and chemotherapy. Overall survival (OS) was significantly influenced by the complication grade. The 5-year OS rates were 43.0%, 42.5%, 25.5% and 9.6% for no complications, and Grade I, Grade II and Grade III complications, respectively (P < 0.001). Age, tumor size, intraoperative blood loss, lymph node metastasis, TNM stage and complication grade were independent prognostic factors in multivariate analysis. With stratified analysis, lymph node metastasis, tumor size, and intraoperative blood loss were independent prognostic factors for Grade I complications (P < 0.001, P = 0.031, P = 0.030). Age and lymph node metastasis were found to be independent prognostic factors for OS of gastric cancer patients with Grade II complications (P = 0.034, P = 0.001). Intraoperative blood loss, TNM stage, and chemotherapy were independent prognostic factors for OS of gastric cancer patients with Grade III complications (P = 0.003, P = 0.005, P < 0.001). There were significant differences among patients with Grade I, Grade II and Grade III complications in TNM stage II and III cancer (P < 0.001, P = 0.001). CONCLUSION: Complication grade may be an independent prognostic factor for gastric cancer following curative resection. Treatment of complications can improve the long-term outcome of gastric cancer patients.


Assuntos
Adenocarcinoma/cirurgia , Gastrectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Neoplasias Gástricas/cirurgia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Idoso , Distribuição de Qui-Quadrado , Feminino , Gastrectomia/mortalidade , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/terapia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Fatores de Tempo , Resultado do Tratamento
12.
Biomarkers ; 19(6): 444-51, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24910346

RESUMO

The objective of this study was to investigate the impact of neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) on the postoperative complication and long-term outcomes in patients with resectable gastric cancer (GC). A total of 377 patients who underwent curative resection for GC were enrolled. In logistic analysis, PLR (p = 0.09) was independently associated with the incidence of postoperative complication. The results of multivariate survival analysis showed the NLR and PLR were introduced as prognostic factors for operable GC, the NLR may represent a useful prognostic index for the prediction of overall survival (OS) in advanced GC (p = 0.021).


Assuntos
Adenocarcinoma/imunologia , Neoplasias Gástricas/imunologia , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Feminino , Humanos , Estimativa de Kaplan-Meier , Contagem de Linfócitos , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Neutrófilos/imunologia , Contagem de Plaquetas , Período Pré-Operatório , Prognóstico , Modelos de Riscos Proporcionais , Curva ROC , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/cirurgia
13.
Tumour Biol ; 35(9): 9429-36, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24972970

RESUMO

The aim of this study was to determine the prognostic value of perineural invasion (PNI) in patients with gastric cancer who underwent curative resection. We retrospectively analyzed 518 patients who had undergone curative gastrectomy. Paraffin sections of surgical specimens from all patients were stained with hematoxylin and eosin. PNI was defined when carcinoma cells infiltrated into the perineurium or neural fascicles. Patients with PNI had a significantly larger tumors (≥5.0 cm), lymphatic venous invasion (positive), deeper tumor invasion (T4), more number of lymph node metastases (N3), and higher tumor stage (III). Regarding survival, multivariate analysis showed that PNI emerged as an independent prognostic factor for survival (hazard ratio (HR) = 1.901, P < 0.001). We incorporated the PNI into the 7th edition tumor-node-metastasis (TNM) staging system. Comparing with the 7th edition staging system, the redefinition of TPNI stage had higher -2loglikelihood value (-2loglikelihood = 3,492.259) and lower HR and 95 % confidence interval (CI) (HR = 1.955, 95 % CI = 1.630-2.343); redefinition of NPNI and TNMIIIPNI stage both had lower -2loglikelihood value (-2loglikelihood = 3,306.608; -2loglikelihood = 2,535.151) and higher HR and 95 % CI (HR = 1.879, 95 % CI = 1.720-2.053; HR = 2.268, 95 % CI = 1.900-2.707), which represented the optimum prognostic stratification, together with better homogeneity, discriminatory ability. Our results showed that the frequency of PNI was high in patients with gastric cancer who underwent curative gastrectomy and the proportion of PNI positivity increased with progression and clinical stage of disease. PNI may be useful in detecting patients who had poor prognosis after curative resection in gastric cancer and it should be incorporated into TNM staging.


Assuntos
Gastrectomia/métodos , Nervos Periféricos/patologia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Invasividade Neoplásica , Estadiamento de Neoplasias , /estatística & dados numéricos , Prognóstico , Modelos de Riscos Proporcionais , Adulto Jovem
14.
World J Gastroenterol ; 20(13): 3640-8, 2014 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-24707149

RESUMO

AIM: To elucidate the potential impact of examined lymph nodes (eLNs) on long-term survival of node-negative gastric cancer patients after curative surgery. METHODS: A total of 497 node-negative gastric cancer patients who underwent curative gastrectomy between January 2000 and December 2008 in our center were enrolled in this study. Patients were divided into 4 groups according to eLNs through cut-point analysis. Clinicopathological features were compared between ≤ 15 eLNs group and > 15 eLNs group and potential prognostic factors were analyzed. The Log-rank test was used to assess statistical differences between the groups. Independent prognostic factors were identified using the Cox proportional hazards regression model. Stratified analysis was performed to investigate the impact of eLNs on patient survival in each stage. Overall survival was also compared among the four groups. Finally, we explored the recurrent sites associated with eLNs. RESULTS: Patients with eLNs > 15 had a better survival compared with those with eLNs ≤ 15 for the entire cohort. By the multivariate survival analysis, we found that the depth of invasion and the number of eLNs were the independent predictors of overall survival (OS) of patients with node-negative gastric cancer. According to the cut-point analysis, T2-T4 patients with 11-15 eLNs had a significantly longer mean OS than those with 4-10 eLNs or 1-3 eLNs. Patients with ≤ 15 eLNs were more likely to experience locoregional and peritoneal recurrence than those with > 15 eLNs. CONCLUSION: Number of eLNs could predict the prognosis of node-negative gastric cancer, and dissection of > 15 eLNs is recommended during lymphadenectomy so as to improve the long-term survival.


Assuntos
Linfonodos/patologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Idoso , Estudos de Coortes , Feminino , Seguimentos , Gastrectomia , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Período Pós-Operatório , Prognóstico , Modelos de Riscos Proporcionais , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia , Resultado do Tratamento
15.
Zhonghua Wai Ke Za Zhi ; 51(3): 230-4, 2013 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-23859324

RESUMO

OBJECTIVE: To investigate the impact of tumor size in the prognosis of T4a stage gastric cancer. METHODS: The best cut-off point depending on tumor size was selected by Kaplan-Meier. Compare cliniclópathological characteristics between small size gastric cancer (SSG) and large size gastric cancer (LSG). Univariate analysis was done by Log-rank test and multivariate analysis was performed using the Cox proportional hazard regression model. The independent prognostic factors of patients were performed subgroup analysis. RESULTS: Eight centimetre was the optimal cut-off of tumor size for T4a stage gastric cancer. There were significantly differences between SSG and LSG in tumor location (χ² = 15.695), histological grade (χ² = 4.393), macroscopic type (χ² = 5.629) and early recurrence (χ² = 4.292). Univariate analysis showed age (χ² = 4.463), tumor size (χ² = 9.057), macroscopic type (χ² = 6.679), histological grade (χ² = 5.122), location of tumor (χ² = 8.707) and N stage (χ² = 132.954) are related to survival (P < 0.05). Among them, tumor size (HR = 1.339), histological grade (HR = 1.169) and N stage (HR = 1.876) were independent risk factor for survival (P = 0.05). For SSG, N stage (HR = 2.014) and histological grade (HR = 1.192) were independent risk factor for survival (P = 0.05), and for LSG, N stage (HR = 1.876) was independent risk factor for survival (P = 0.000). Further stratified analysis indicated that the 5-year survival rate of LSG is significantly lower than that of SSG in T4a stage patients of gastric cancer without lymph nodes metastasis or poorly differentiated (HR = 0.182 and 0.653, P < 0.01). CONCLUSIONS: Tumor size is an independent prognostic factor in patients of T4a stage gastric cancer. Tumor size cut-off point of 8 cm can exert significant impact on the prognosis of T4a stage gastric cancer without lymph nodes metastasis or poorly differentiated.


Assuntos
Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Estômago/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Prognóstico , Taxa de Sobrevida
16.
Zhonghua Wai Ke Za Zhi ; 51(3): 235-9, 2013 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-23859325

RESUMO

OBJECTIVE: To evaluate the feasibility and necessity of No.13 lymph node dissection in D2 radical gastrectomy for lower-third advanced gastric cancer (AGC). METHODS: Data of 379 cases who were diagnosed as TNM II-III stage AGC were collected from January 2001 to June 2007. One hundred cases who undergone No.13 lymph node dissection during D2 gastrectomy for lower-third AGC were selected as study group. Other 279 cases (control group) received only D2 gastrectomy. The differences in clinicopathologic and intraoperative and postoperative parameters and 5-years survival rate were compared using the SPSS 17.0 software. RESULTS: There were no significant differences between the two groups in patients' gender, age, tumor size, histologic type, Borrmann type, duodenum invasion, tumor depth, lymph node metastasis, TNM classification, operative time, blood loss and the incidence of postoperative complications (P > 0.05). In the study group, there were 9 patients with positive No. 13 lymph node, and its 5-year survival rate (46.0%) was higher than the control group (36.5%, χ² = 4.452, P < 0.05). The Univariate analysis showed that age (χ² = 7.539), No.13 lymph node dissection (χ² = 4.452), tumor size (χ² = 7.100), duodenum invasion (χ² = 9.106), tumor depth (χ² = 7.428), lymph node metastasis (χ² = 45.046), TNM classification (χ² = 57.008) are associated with prognosis of lower-third AGC (P < 0.05). Multivariate analysis identified age (HR = 0.500, 95% CI: 0.343 - 0.730), tumor size (HR = 0.545, 95%CI: 0.339 - 0.876), duodenum invasion (HR = 5.821, 95%CI: 2.326 - 14.572), and tumor depth (T4: HR = 2.087, 95% CI: 1.283 - 3.394) as independent prognostic factors (P < 0.05). CONCLUSION: No. 13 lymph node dissection for TNM II-III stage lower-third advanced gastric cancer is feasible and necessary.


Assuntos
Excisão de Linfonodo , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastrectomia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco , Neoplasias Gástricas/mortalidade , Taxa de Sobrevida , Adulto Jovem
17.
Zhonghua Wei Chang Wai Ke Za Zhi ; 16(7): 632-6, 2013 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-23888444

RESUMO

OBJECTIVE: To elucidate the necessity of No.14v lymph node dissection in D2 lymphadenectomy for advanced gastric cancer. METHODS: Clinicopathological data of 131 cases of advanced gastric cancer receiving D2 or D2+ plus No.14v lymph node dissection were reviewed retrospectively. Clinicopathological factors associated with No.14v lymph node metastasis were analyzed and prognostic value of No.14v lymph node metastasis was evaluated. RESULTS: Of the 131 patients, 24 (18.3%) had positive No.14v lymph node. The incidence of 14v metastasis was associated with tumor location, tumor size, depth of invasion, N staging, TNM staging, No.1, No.6, and No.8a lymph nodes metastasis. Tumor location and N staging were independent risk factors for No.14v metastasis (all P<0.05). The 5-year survival rate was 8.3% and 37.8% in patients with and without No.14v metastasis respectively. The difference was statistically significant (P<0.01). Multivariate analysis revealed that metastasis of No.14v was an independent prognostic factor for advanced gastric cancer after D2 lymphadenectomy (P=0.029, RR=1.807, 95%CI:1.064-3.070). CONCLUSIONS: For advanced middle and lower gastric cancers, especially those with larger size, serosa invasion and possibility of No.6 lymph node metastasis, it is necessary and feasible to remove the No.14v lymph node.


Assuntos
Excisão de Linfonodo/métodos , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
18.
Tumour Biol ; 34(6): 3627-36, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23824571

RESUMO

Suppressor of cytokine signaling-3 (SOCS-3), a multifunctional cytokine, is able to inhibit cell growth and migration by blocking the Janus kinase signal transducers and activators of transcription signaling (JAK/STAT) activation in oncogenesis. Although the STAT-3 expression was associated with lymph node metastasis from gastric cancer (GC), the implication of SOCS-3 expression in GC is not clearly elucidated. In this study, SOCS-3, STAT-3, and pSTAT-3 were evaluated in GC tissues and adjacent non-tumor tissues of 107 patients who underwent curative surgery by immunohistochemistry. Further, SOCS-3 and STAT-3 mRNA levels were also detected simultaneously. In addition, survival analysis was performed between clinicopathologic variables and prognosis of GC patients. Finally, correlative analysis was adopted for demonstration the best predicator of the survival independent factor. From the results, we demonstrated that only the lymph node metastasis was the independent predictor of the overall survival (OS) of GC patients, although SOCS-3, STAT-3, and other variables were significantly relative to OS. With multivariate logistical regression analysis, SOCS-3, STAT-3, and the status of extragastric nodal metastasis were identified to be the independent factors of the lymph node metastasis from GC. Ultimately, the SOCS-3 was the best predicator of lymph node metastasis from GC identified with the nominal regression analysis. Therefore, SOCS-3 should be considered as a potential indicator for prediction the lymph node metastasis from GC.


Assuntos
Mucosa Gástrica/metabolismo , Fator de Transcrição STAT3/metabolismo , Neoplasias Gástricas/metabolismo , Proteínas Supressoras da Sinalização de Citocina/metabolismo , Adulto , Idoso , Feminino , Seguimentos , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Modelos Logísticos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Fosforilação , Prognóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fator de Transcrição STAT3/genética , Estômago/patologia , Estômago/cirurgia , Neoplasias Gástricas/genética , Neoplasias Gástricas/cirurgia , Proteína 3 Supressora da Sinalização de Citocinas , Proteínas Supressoras da Sinalização de Citocina/genética , Adulto Jovem
19.
Zhonghua Wai Ke Za Zhi ; 51(1): 66-70, 2013 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-23578432

RESUMO

OBJECTIVE: To evaluate the value of negative lymph node count (NLNC) in prediction of prognosis of advanced gastric cancer after radical resection. METHODS: The 544 cases of radical gastrectomy patients with complete clinical and follow-up data between January 2011 and July 2007 were collected. Survival was determined by the Kaplan-Merier method and univariate analysis was done by Log-rank test, Multivariate analysis was performed using the Cox proportional hazard regression model. RESULTS: Univariate analysis showed age (χ(2) = 4.449), T stage (χ(2) = 30.482), N stage (χ(2) = 205.452), location of tumor (χ(2) = 16.649), tumor size (χ(2) = 35.117), macroscopic type (χ(2) = 4.750), histological grade (χ(2) = 6.130), NLNC stage (χ(2) = 150.369) and type of gastrectomy (χ(2) = 25.605) were related to survival. Among them, T stage, N stage, tumor size and NLNC stage were independent risk factors for survival (P < 0.05). The prognostic factors of patients were performed subgroup analysis, NLNC > 15 group can prolong the survival than NLNC ≤ 15 group in the T2 stage (HR = 0.315), T4 stage (HR = 0.401), the same classification of location of tumor (HR = 0.286-0.493), tumor size (HR = 0.336, 0.465), macroscopic type (HR = 0.306, 0.418), histological grade (HR = 0.411, 0.365) and type of gastrectomy (HR = 0.444, 0.358 and 0.356, all P < 0.05). More NLNC can prolong Disease-Free Survival for patient of early recurrence (χ(2) = 8.648, P = 0.003). CONCLUSIONS: Sufficient negative lymph node count can prolong the survival and decrease the risk of early recurrence.


Assuntos
Excisão de Linfonodo , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia/prevenção & controle , Prognóstico , Modelos de Riscos Proporcionais , Neoplasias Gástricas/mortalidade
20.
Int J Surg ; 11(5): 419-24, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23541652

RESUMO

OBJECTIVE: The aim of the study was to investigate the most appropriate system for categorization of metastatic lymph nodes among N staging (according to the 7th edition UICC/AJCC TNM Classification for Gastric Cancer), ratio between metastatic and examined lymph nodes (RML) staging, negative lymph nodes (NLN) staging and log odds of positive lymph nodes (LODDS) staging for evaluation the overall survival (OS) of gastric cancer. METHODS: We reviewed clinicopathological data of 372 gastric cancer patients who underwent radical gastrectomy plus extended lymphadenectomy with the purpose of evaluating the differences in the OS according to different categories of metastatic lymph nodes. RESULTS: Univariate and multivariate analysis of data significantly identified the degree of differentiation (HR = 1.404, p = 0.015), T staging (according to the 7th edition UICC/AJCC TNM Classification for Gastric Cancer) (HR = 1.568, p = 0.024) and the RML staging (HR = 1.479, p = 0.030) as independent predictors of the OS. However, RML staging was identified as the most appropriate for evaluating the OS of gastric cancer patients following radical gastrectomy plus extended lymphadenectomy rather than N staging, NLN staging and LODDS staging by using the case-control matched analysis. With the further stratified analysis, we demonstrated that RML staging had the best prognostic homogeneity than LODDS staging, NLN staging or N staging. CONCLUSIONS: RML staging was the best system for prediction the OS of the gastric cancer patients following radical gastrectomy plus extended lymphadenectomy, rather than LODDS staging, NLN staging or N staging.


Assuntos
Linfonodos/patologia , Neoplasias Gástricas/patologia , Adulto , Idoso , Análise de Variância , Feminino , Gastrectomia , Humanos , Estimativa de Kaplan-Meier , Excisão de Linfonodo , Linfonodos/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Neoplasias Gástricas/cirurgia
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