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Biosci Rep ; 39(1)2019 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-30578380


A consensus about the prognostic role of NIMA-related kinase 2 (NEK2) expression in various solid tumors has not been made yet. Thus, this meta-analysis aimed to systematically assess the prognostic role of NEK2 expression in patients with solid tumors. The eligible studies were identified through searching PubMed, Web of Science, and EMBASE. The hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) were used to evaluate the link between NEK2 overexpression and overall survival (OS) and disease-free survival/recurrence-free survival (DFS/RFS) of patients with solid tumors. A total of 17 studies with 4897 patients were included in this meta-analysis. Among these studies, all of them explored the association between NEK2 expression and OS of patients with solid tumors. Our pooled analysis indicated that NEK2 overexpression was significantly related to adverse OS (HR = 1.66; 95% CI: 1.38-2.00; P = 0.001). Additionally, there were six studies with 854 patients that investigated the association between NEK2 expression and DFS/RFS. Our pooled result indicated that there was a substantial relationship between NEK2 overexpression and poorer DFS/RFS (HR = 2.00; 95% CI: 1.61-2.48; P = 0.003). In conclusion, our meta-analysis indicated that NEK2 may be a useful predictor of prognosis and an effective therapeutic target in solid tumors. Nevertheless, more high-quality studies are warranted to further support our conclusions because of several limitations in our meta-analysis.

Biomarcadores Tumorais/genética , Quinases Relacionadas a NIMA/genética , Neoplasias/genética , Prognóstico , Intervalo Livre de Doença , Humanos , Neoplasias/patologia
Medicine (Baltimore) ; 97(46): e13151, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30431587


BACKGROUND: Several studies were conducted to investigate the prognostic value of pretreatment serum lactate dehydrogenase (LDH) level in pancreatic cancer (PC), but the results were inconsistent. This study aims to comprehensively assess the prognostic value of pretreatment serum LDH level in PC patients by combining the data of the published literatures on this topic. METHODS: Embase, PubMed, and Web of Science were completely retrieved until June, 2018. The observational studies focusing on the prognostic value of pretreatment serum LDH level in PC patients were eligible. STATA version 12.0 was used to undertake the statistical analysis. RESULTS: Eighteen studies with a total of 3345 patients were included in this meta-analysis. The meta-analysis was conducted to generate pooled hazard ratios (HRs) and 95% confidence interval (CI) for overall survival (OS). Our analysis results suggested that high serum LDH level predicted worse OS (HR 1.57, 95% CI 1.30-1.90, P < .001) in PC patients. Moreover, for patients with advanced PC, the prognostic relevance of pretreatment serum LDH level not only existed in those receiving palliative chemotherapy (HR 1.72, 95% CI 1.35-2.18, P < .001), but also in those who were precluded from chemotherapy (HR 1.91, 95% CI 1.4219-2.58, P < .001). CONCLUSION: The meta-analysis results demonstrated that pretreatment serum LDH level is closely associated with OS, and it may be a useful biomarker for assessing the prognosis of PC patients.

Int J Surg ; 44: 176-184, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28583892


BACKGROUNDS: Updated guidelines for surgical site infections (SSIs) suggested that chlorhexidine (CH) or povidone-iodine (PVI) product was equally appropriate to be applied in preoperative disinfection, but which one was optimal remained ambiguous. Moreover, recent studies reported inconsistent results. Thus, an updated meta-analysis was conducted to clarify the superiority of CH or PVI for prevention of SSIs in clean and clean-contaminated surgery. METHODS: From the inception to November 2016, Pubmed, Embase, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) which explored preoperative antisepsis schemes (CH or PVI) for prevention of SSIs in clean and clean-contaminated surgery. Relative risks (RRs) with 95% confidence interval (CI) were calculated using random effects model. Furthermore, subgroup analysis, sensitive analysis, and trial sequential analysis (TSA) were applied to estimate whether overall pooled effect was enough credible and robust. RESULTS: Thirteen RCTs involving 6997 patients (3352 in CH and 3645 in PVI group) undergoing clean and clean-contaminated surgeries were included in our meta-analysis. Compared with PVI, preoperative CH antisepsis was associated with lower incidence of SSIs (RR, 0.70; 95%CI, 0.60-0.83, I2 = 0). Additionally, subgroup analysis, sensitive analysis, and TSA indicated that the current available evidence was reliable and robust. CONCLUSIONS: CH should be more preferentially recommended for preoperative skin preparation as compared with PVI in clean and clean-contaminated surgery.

Anti-Infecciosos Locais/uso terapêutico , Antissepsia/métodos , Clorexidina/uso terapêutico , Povidona-Iodo/uso terapêutico , Infecção da Ferida Cirúrgica/prevenção & controle , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
J Surg Res ; 209: 17-29, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28032555


BACKGROUND: European Hernia Society guidelines suggested that the evidence of mesh augmentation for the prevention of incisional hernia (IH) was weak. In addition, previous systematic reviews seldom focused on quality of life and cost-effectiveness related to mesh placement. Therefore, an updated meta-analysis was performed to clarify quality of life, cost-effectiveness, the safety, and effectiveness of mesh reinforcement in preventing the incidence of IH. METHODS: Embase, Pubmed, and the Cochrane library were searched from the inception to May 2016 without language limitation for randomized controlled trials (RCTs) which explored mesh reinforcement for the prevention of IH in patients undergoing abdominal surgeries. RESULTS: Twelve RCTs totaling 1661 patients (958 in mesh, 703 in nonmesh) were included in our study. Compared with nonmesh, mesh reinforcement can effectively decrease the incidence of IH (relative risk: 0.19; 95% CI: 0.09-0.42). Besides, mesh placement was associated with improved quality of life, a higher rate of seroma (relative risk: 1.64; 95% CI: 1.13-2.37), and longer operating time (mean difference: 17.62; 95% CI: 1.44-33.80). No difference can be found between both groups in postoperative overall morbidity, systemic postoperative morbidity, wound-related morbidity, surgical site infection, hematoma, wound disruption, postoperative mortality, and length of hospital stay. CONCLUSIONS: Prophylactic mesh reinforcement may be effective and safe to prevent the formation of IH after abdominal surgery, without impairing quality of life. Thus, preventive mesh should be routinely recommended in high-risk patients.

Hérnia Incisional/prevenção & controle , Telas Cirúrgicas , Análise Custo-Benefício , Humanos , Hérnia Incisional/mortalidade , Tempo de Internação , Duração da Cirurgia , Dor Pós-Operatória , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
Cell Biochem Biophys ; 67(3): 1033-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23625175


Glycolytic pyruvate kinase isoenzyme type M2 (M2-PK) plays a key role in tumor metabolism and energy production. Vascular endothelial growth factor (VEGF) is critical in regulating angiogenesis which is an essential process required for tumor growth and metastasis. These two genes may function in accordance with tumor development. The purpose of this study was to investigate the relationship between the expression of M2-PK and VEGF, and their association with clinicopathological features in patients with advanced gastric cancer. Expression of M2-PK and VEGF were examined in 142 cases of paraffin-embedded tissue blocks from patients with advanced gastric cancer. M2-PK expression was found to strongly correlate with that of VEGF (r = 0.718). In addition, expression of M2-PK and VEGF correlates with tumor size (p = 0.0001, and p = 0.0017, respectively), depth of invasion (p = 0.0024, and p = 0.0261, respectively), and lymph node metastasis (p = 0.036, and p = 0.028, respectively). The high expression levels of M2-PK and VEGF may indicate poor prognosis in patients with advanced gastric cancer.

Regulação Neoplásica da Expressão Gênica , Piruvato Quinase/genética , Neoplasias Gástricas/genética , Neoplasias Gástricas/fisiopatologia , Fator A de Crescimento do Endotélio Vascular/genética , Idoso , Antimetabólitos Antineoplásicos/uso terapêutico , Feminino , Fluoruracila/uso terapêutico , Seguimentos , Humanos , Imuno-Histoquímica , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Piruvato Quinase/metabolismo , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/mortalidade , Análise de Sobrevida , Fator A de Crescimento do Endotélio Vascular/metabolismo
ISRN Gastroenterol ; 2013: 464053, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23509634


Aim. To compare the effectiveness of surgical procedures (selective or nonselective shunt, devascularization, and combined shunt and devascularization) in preventing recurrent variceal bleeding and other complications in patients with portal hypertension. Methods. A systematic literature search of the Medline and Cochrane Library databases was carried out, and a meta-analysis was conducted according to the guidelines of the Quality of Reporting Meta-Analyses (QUOROM) statement. Results. There were a significantly higher reduction in rebleeding, yet a significantly more common encephalopathy (P = 0.05) in patients who underwent the shunt procedure compared with patients who had only a devascularization procedure. Further, there were no significant differences in rebleeding, late mortality, and encephalopathy between selective versus non-selective shunt. Next, the decrease of portal vein pressure, portal vein diameter, and free portal pressure in patients who underwent combined treatment with shunt and devascularization was more pronounced compared with patients who were treated with devascularization alone (P < 0.05). Conclusions. This meta-analysis shows clinical advantages of combined shunt and devascularization over devascularization in the prevention of recurrent variceal bleeding and other complications in patients with portal hypertension.