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Body mass index does not affect the survival of pancreatic cancer patients

World Journal of Gastroenterology 2017年第34期23卷 6287-6293页

作者： Qing-long Jiang Cheng-feng Wang Yan-tao tian Huang Huang Shui-Sheng Zhang Dong-bing Zhao Jie Ma Wei Yuan Yue-Min Sun Xu Che Jian-Wei Zhang Yun-Mian Chu Ya-Wei Zhang Ying-tai Chen Department of Pancreatic and Gastric Surgery National Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Department of Surgery Yale School of MedicineYale Cancer Center

AIM to evaluate the association of body mass index(b MI) with the overall survival of pancreatic ductal adenocarcinoma(PDAC) *** A retrospective analysis of PDAC patients diagnosed in the National Cancer Center of China between January 1999 and December 2014 was performed. these patients were categorized into four b MI groups(survival analysis was performed with the Kaplan-Meyer method. their HRs of mortality and 95%CIs were estimated using the Cox proportional hazards *** With a median age of 59.6 years(range: 22.5-84.6 years), in total 1783 PDAC patients were enrolled in this study. their mean usual b MI was 24.19 ± 3.53 for the whole cohort. More than half of the patients(59.3%) experienced weight loss during the disease onset and progression. Compared with healthy-weight individuals, newly diagnosed patients who were overweight or obese had more severe weight loss during their disease onset and progression(P survival analysis showed no association between b MI and the overall survival(P = 0.90, n = 1783). When we stratified the whole cohort by pancreatic cancer stage, no statistically significant association between b MI and overall survival was found for resectable(P = 0.99, n = 217), unresectable locally advanced(P = 0.90, n = 316) and metastatic patients(P = 0.88, n = 1250), respectively. the results did not change when we used the b MI at *** Our results showed no significance of b MI for the overall survival of PDAC pati

关键词： body mass index Pancreatic cancer Overweight Smoking history survival analysis

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Risk factors affecting the mortality of HIVinfected patients with pulmonary tuberculosis in the cART era:a retrospective cohort study in China

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Infectious Diseases of Poverty 2018年第1期7卷 255-263页

作者： Yong-Jia Ji Pei-Pei Liang Jia-Yin Shen Jian-Jun Sun Jun-Yang Yang Jun Chen Tang-Kai Qi Zhen-Yan Wang Wei Song Yang Tang Li Liu Ren-Fang Zhang Yin-Zhong Shen Hong-Zhou Lu Department of Infectious Disease Shanghai Public Health Clinical CenterFudan UniversityNo.2901 Cao Lang RdJinshan DistrictShanghai 201508China Department of Infectious Disease Huashan Hospital Affiliated to Fudan UniversityShanghai 200040China Department of Internal Medicine Shanghai Medical CollegeFudan UniversityShanghai 200032China

Background:Tuberculosis infection still places a great burden on HIV-infected individuals in China and other developing *** of the survival of HIV-infected patients with pulmonary tuberculosis(PTB)would provide important insights for the clinical management of this population,which remains to be well described in current ***:HIV-infected patients with PTB admitted to Shanghai Public Health Clinical Center from January 2011 to December 2015 were retrospectively *** this cohort,the survival prognosis was estimated by the Kaplan-Meier method,while univariate and multivariate Cox proportional hazards models were used to determine the risk factors affecting ***:After reviewing 4914 admitted patients with HIV infection,359 PTB cases were *** the time of PTB diagnosis,the patients’median CD4+T cell count was 51/mm3(IQR:23-116),and 27.30%of patients(98/359)were on combination antiretroviral therapy(cART).For the 333 cases included in the survival analysis,the overall mortality was 15.92%(53/333)during a median 27-month *** risk factors,including age older than 60 years(HR:3.18;95%CI:1.66-6.10),complication with bacterial pneumonia(HR:2.64;95%CI:1.30-5.35),diagnosis delay(HR:2.60;95%CI:1.42-4.78),CD4+T cell count less than 50/mm3(HR:2.38;95%CI:1.27-4.43)and pulmonary atelectasis(HR:2.20;95%CI:1.05-4.60),might independently contribute to poor *** patients without cART before anti-TB treatment,the later initiation of cART(more than 8 weeks after starting anti-TB treatment)was found to increase the mortality rate(OR:4.33;95%CI:1.22-15.36),while the initiation of cART within 4-8 weeks after starting anti-TB treatment was associated with the fewest deaths(0/14).Conclusions:The subjects in this study conducted in the cART era were still characterized by depressed immunological competence and low rates of cART administration,revealing possible intervention targets for preventing TB reactivation in HIV-in

关键词： HIV infections Acquired immunodeficiency syndrome Pulmonary tuberculosis survival analysis

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Associations between Lesion Locations and Stroke Recurrence in Survivors of First-ever Ischemic Stroke:A Prospective Cohort Study

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Current Medical Science 2020年第4期40卷 708-718页

作者： Pe-jing YANI Li-sha HOU Mi-er LI Zhen-xing LU Feng-yu ZHAN Meng-dong RAN Ji-je LI Lu ZHANG Rong YANG Mu-ke ZHOU Cai-rong ZHU Department of Epidemiology and Health Statistics West China School of Public Health and West China Fourh HospitalSichuan UniversityChengdu 610044China National Clinical Research Center for Geriatrics West China HospitalSichuan UniversityChengdu 610044China The First Clinical College of Lanzhou University Lanzhou 730000China Department of Medical Record West China Second University SchoolChengdu 610044China Department of Neurology West China Hospital of Sichuan UniversitChengdu 610044China

Summary:Several studies have indicated that stroke survivors with multiple lesions or with larger lesion volumes have a higher risk of stroke ***,the relationship between lesion locations and stroke recurrence is *** conducted a prospective cohort study of first-ever ischemic stroke survivors who were consecutively enrolled from January 2010 to December *** recurrence was assessed every 3 months after post-discharge via telephone interviews by trained *** locations were obtained from hospital-based MRI or CT scans and classified using two classification systems that were based on cerebral hemisphere or vascular territory and brain anatomical *** parametric survival models using the proportional hazards scale(PH model)were used to analyze the time-to-event *** 633 survivors,63.51%(n-402)had anterior circulation ischemia(ACI),and morc than half of all ACIs occurred in the *** a median follow-up of 2.5 years,117(18.48%)survivors developed a recurrent *** results of the multivariate PH model showed that survivors with non-brain lesions were at higher risk of recurrence than those with right-side lesions(HR,2.79;95%CI,1.53,5.08;P-0.001).There was no increase in risk among survivors with left-side lesions(HR,0.97;95%CI,0.53,1.75;P=0.914)or both-side lesions(HR,1.24;95%CI,0.75,2.07;P-0.401)compared to those with right-side ***,there were no associations between stroke ecurrence and lesion locations that were classified based on vascular territory and brain anatomical *** was concluded that first-ever ischemic stroke survivors with non-brain lesion had higher recurrence risk than those with right-side lesion,although no significant associations were found when the lesion locations were classified by vascular territory and brain anatomical structures.

关键词： ischemic stroke lesion location prevention recurrence flexible parametric survival models survival analysis

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Impact factors of lymph node retrieval on survival in locally advanced rectal cancer with neoadjuvant therapy

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World Journal of Clinical Cases 2020年第24期8卷 6229-6242页

作者： Shi-Wen Mei Zheng Liu Zheng Wang Wei Pei Fang-Ze Wei Jia-Nan Chen Zhi-Jie Wang Hai-Yu Shen Juan Li Fu-Qiang Zhao Xi-Shan Wang Qian Liu Department of Colorectal Surgery National Cancer Center/National Clinical Research Center for Cancer/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND Conventional clinical guidelines recommend that at least 12 lymph nodes shouldbe removed during radical rectal cancer surgery to achieve accurate *** application of neoadjuvant therapy has changed the number of lymphnode *** To investigate factors affecting the number of lymph nodes dissected afterneoadjuvant chemoradiotherapy in locally advanced rectal cancer and to evaluatethe relationship of the total number of retrieved lymph nodes(TLN)with diseasefreesurvival(DFS)and overall survival(OS).METHODS A total of 231 patients with locally advanced rectal cancer from 2015 to 2017 wereincluded in this *** to the American Joint Committee on Cancer(AJCC)/Union for International Cancer Control(UICC)tumor-node-metastasis(TNM)classification system and the NCCN guidelines for rectal cancer,thepatients were divided into two groups:group A(TLN≥12,n=177)and group B(TLN<12,n=54).Factors influencing lymph node retrieval were analyzed byunivariate and binary logistic regression *** and OS were evaluated byKaplan-Meier curves and Cox regression *** The median number of lymph nodes dissected was 18(range,12-45)in group A and 8(range,2-11)in group *** lymph node ratio(number of positive lymphnodes/total number of lymph nodes)(P=0.039)and the interval betweenneoadjuvant therapy and radical surgery(P=0.002)were independent factors ofthe ***,TLN was not associated with sex,age,ASA score,clinical T orN stage,pathological T stage,tumor response grade(Dworak),downstaging,pathological complete response,radiotherapy dose,preoperative concurrentchemotherapy regimen,tumor distance from anal verge,multivisceral resection,preoperative carcinoembryonic antigen level,perineural invasion,intravasculartumor embolus or degree of *** pathological T stage(P<0.001)and TLN(P<0.001)were independent factors of DFS,and pathological T stage(P=0.011)and perineural invasion(P=0.002)were independent factors of ***

关键词： Lymph node retrieval survival analysis Neoadjuvant therapy Rectal cancer Tumor-node-metastasis stage Prognosis

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Gene signatures associated with genomic aberrations predict prognosis in neuroblastoma

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Cancer Communications 2020年第2期40卷 105-118页

作者： Xiaoyan He Chao Qin Yanding Zhao Lin Zou Hui Zhao Chao Cheng Center for Clinical Molecular Medicine Ministry of Education Key Laboratory of Child Development and DisordersNational Clinical Research Center for Child Health and DisordersChina International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqing Key Laboratory of PediatricsChildren’s Hospital of Chongqing Medical UniversityChongqing 400014P.R.China Beijing Key Lab of Traffic Data analysis and Mining School of Computer and Information TechnologyBeijing Jiaotong UniversityBeijing 100044P.R.China Department of Biomedical Data Science Geisel School of Medicine at DartmouthLebanonNH 03766USA School of Biomedical Sciences Faculty of MedicineThe Chinese University of Hong KongHong Kong 999077P.R.China Department of Medicine Baylor College of MedicineHoustonTX 77030USA Institute for Clinical and Translational Research Baylor College of MedicineHoustonTX 77030USA

Background:Neuroblastoma(NB)is a heterogeneous disease with respect to genomic abnormalities and clinical *** recent advances in our understanding of the association between the genetic aberrations and clinical features,it remains one of the major challenges to predict prognosis and stratify patients for determining personalized therapy in this *** aim of this study was to develop an effective prognosis prediction model for NB ***:We integrated diverse computational analyses to define gene signatures that reflect MYCN activity and chromosomal aberrations including deletion of chromosome 1p(Chr1p_del)and chromosome 11q(Chr11q_del)as well as chromosome 11q whole loss(Chr11q_wls).We evaluated the prognostic and predictive values of these signatures in seven NB gene expression datasets(the number of samples ranges from 94 to 498,with a total of 2120)generated from both RNA sequencing and microarray ***:MYCN signature was a more effective prognostic marker than MYCN amplification status and MYCN ***,the Chr1p_del score was more prognostic than Chr1p *** activity scores of MYCN,Chr1p_del and Chr11q_del were associated with poor prognosis,while the Chr11q_wls score was linked to good *** integrated the activity scores of MYCN,Chr1p_del,Chr11q_del,and Chr11q_wls and clinical variables into an integrative prognostic model,which displayed significant performance over the clinical variables or each genomic aberration ***:Our integrative gene signature model shows a significantly improved forecast performance with prognostic and predictive information,and thereby can be served as a biomarker to stratify NB patients for prognosis evaluation and surveillance programs.

关键词： chromosome aberration gene expression profile MYCN gene neuroblastoma prognosis survival analysis

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Artificial intelligence recognition of pathological T stage and tumor invasion in rectal cancer based on large panoramic pathological sections

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Intelligent Medicine 2022年第3期2卷 141-151页

作者： Yiheng Ju Longbo Zheng Peng Zhao Fangjie Xin Fengjiao Wang Yuan Gao Xianxiang Zhang Dongsheng Wang Yun Lu Department of General Surgery Medical CenterAffiliated Hospital of Qingdao UniversityQingdaoShandong 266000China Department of Pathology Affiliated Hospital of Qingdao UniversityQingdaoShandong 266000China Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery QingdaoShandong 266071China Hainan Branch of Affiliated Hospital of Qingdao University Lingshui Li Autonomous CountyHainan 572400China

Background The incidence of colorectal cancer is increasing worldwide,and it currently ranks third among all ***,pathological diagnosis is becoming increasingly *** intelligence has demon-strated the ability to fully excavate image features and assist doctors in making *** panoramic patho-logical sections contain considerable amounts of pathological *** this study,we used large panoramic pathological sections to establish a deep learning model to assist pathologists in identifying cancerous areas on whole-slide images of rectal cancer,as well as for T staging and prognostic *** We collected 126 cases of primary rectal cancer from the Affiliated Hospital of Qingdao University West Coast Hospital District(internal dataset)and 42 cases from Shinan and Laoshan Hospital District(external dataset)that had tissue surgically removed from January to September *** sectioning,staining,and scanning,a total of 2350 hematoxylin-eosin-stained whole-slide images were *** patients in the internal dataset were randomly divided into a training cohort(n=88)and a test cohort(n=38)at a ratio of 7:*** chose DeepLabV3+and ResNet50 as target models for our *** used the Dice similarity coefficient,accuracy,sensitivity,specificity,receiver operating characteristic(ROC)curve,and area under the curve(AUC)to evaluate the performance of the artificial intelligence platform in the test set and validation ***,we followed up patients and examined their prognosis and short-term survival to corroborate the value of T-staging *** In the test set,the accuracy of image segmentation was 95.8%,the Dice coefficient was 0.92,the accuracy of automatic T-staging recognition was 86%,and the ROC AUC value was *** the validation set,the accuracy of image segmentation was 95.3%,the Dice coefficient was 0.90,the accuracy of automatic classification was 85%,the ROC AUC value was 0.92,and the imag

关键词： Large panoramic pathological sections Rectal cancer Whole-slide imaging Deep learning survival analysis

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Clinical characteristics and outcome of primary hepatic neuroendocrine tumors after comprehensive therapy

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World Journal of Gastrointestinal Oncology 2020年第9期12卷 1031-1043页

作者： Hao-Hao Wang Zhao-Chen Liu Gong Zhang Lu-Hao Li Lin Li Qing-Bo Meng Pei-Ju Wang Dong-Qi Shen Xiao-Wei Dang Department of Hepatopancreatobiliary Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000Henan ProvinceChina

BACKGROUND Primary hepatic neuroendocrine tumors(PHNETs),a group of neuroendocrine neoplasms,are extremely *** are only few case reports about PHNETs in the *** lack of large samples and multicenter research results in poor diagnostic and therapeutic *** To discuss the clinical characteristics,diagnosis,and treatment of PHNETs and risk factors related to *** We retrospectively analyzed the clinical data,imaging features,immunohistochemistry data,and treatment efficacy of 40 patients who were pathologically diagnosed with PHNETs and admitted to The First Affiliated Hospital of Zhengzhou University from January 1,2014 to November 15,***,survival analysis was performed to identify the risk factors for *** The main symptoms and signs included intermittent abdominal pain(19 patients,47.5%)and bloating(8 patients,20.0%).The positive rates of tested tumor markers were recorded as follows:Carbohydrate antigen 19-9(CA19-9)(6 patients,15.0%),CA72-4(3 patients,7.5%),carcinoembryonic antigen(7 patients,17.5%),and alpha-fetoprotein(6 patients,15.0%).Immunohistochemical staining results showed positivity for Syn in 38(97.4%)of 39 patients,for chromogranin A in 17(65.4%)of 26 patients,for CD56 in 35(94.6%)of 37 patients,for AE1/AE3 in 28(87.5%)of 32 patients,and for Ki-67 in all 40(100.0%)*** overall survival rate was significantly related to the tumor grade,AE1/AE3,and *** number,tumor size,metastasis,and treatment)and overall *** Higher grade,negative AE1/AE3,and higher Ki-67 are associated with a worse survival *** of treatment and other parameters have no significant influence on overall survival.

关键词： Neuroendocrine tumors Primary hepatic neuroendocrine tumors Diagnosis survival analysis Tumor grade Treatment

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TNM staging of colorectal cancer should be reconsidered by T stage weighting

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World Journal of Gastroenterology 2014年第17期20卷 5104-5112页

作者： Jun Li Bao-Cai Guo Li-Rong Sun Jian-Wei Wang Xian-Hua Fu Su-Zhan Zhang Graeme Poston Ke-Feng Ding Department of Surgical Oncology Second Affiliated Hospitaland The Key Laboratory of Cancer Prevention and InterventionChina National Ministry of EducationZhejiang University College of Medicine Department of Applied Mathematics School of Statistics and MathematicsZhejiang Gongshang UniversityXiasha University Town Department of Surgery Aintree University HospitalLiverpool L9 7ALUnited Kingdom

AIM: To verify that the T stage has greater weight than the N stage in the staging of colorectal cancer.

关键词： Colorectal cancer Neoplasm staging Cluster analysis survival analysis Observational study

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Prognostic impact of number of examined lymph nodes on survival of patients with appendiceal neuroendocrine tumors

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World Journal of Clinical Cases 2022年第30期10卷 10906-10920页

作者： Rui Du Jiang-Wei Xiao Department of Gastrointestinal Surgery The First Affiliated Hospital of Chengdu Medical CollegeChengdu 610500Sichuan ProvinceChina

BACKGROUND The prognosis of patients with appendiceal neuroendocrine tumors(ANETs) is related to lymph node(LN) metastasis and other ***,it is unclear how the number of examined LNs(ELNs) impact on *** To determine the factors affecting the cancer-specific survival(CSS) of patients with ANET and to evaluate the impact of the number of ELNs on *** A total of 4583 ANET patients were analyzed in the Surveillance,Epidemiology,and End Results *** survival analysis was used to identify factors related to survival and the optimal number of ELNs and lymph node ratio(LNR) were determined by the Kaplan–Meier *** survival difference was determined by *** Except for sex,the other factors,such as age,year,race,grade,histological type,stage,tumor size,ELNs,LNR,and surgery type,were associated with *** 3-,5-,and 10-year CSS rates of ANET patients were 91.2%,87.5,and 81.7%,respectively(median follow-up period of 31 mo and range of 0-499 mo).There was no survival difference between the two surgery types,namely,local resection and colectomy or greater,in both stratifications of tumor size ≥ 2 cm(P = 0.523)and survival than those with values of 0.17-0.48(χ~2 = 48.243,P < 0.001) and 0.49-1(χ~2 = 168.485,P < 0.001).CONCLUSION ANET ≥ 2 cm are more likely to develop LN *** least 11 ELNs are required to better evaluate the *** patients with posi

关键词： Appendiceal neoplasm Neuroendocrine tumors Carcinoid tumor Lymph node dissection Lymph node ratio survival analysis

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Prognostic value of preoperative enhanced computed tomography as a quantitative imaging biomarker in pancreatic cancer

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World Journal of Gastroenterology 2022年第22期28卷 2468-2481页

作者： Jian-Feng Gao Yu Pan Xian-Chao Lin Feng-Chun Lu Ding-Shen Qiu Jun-Jun Liu He-Guang Huang Department of General Surgery Fujian Medical University Union HospitalFuzhou 350001Fujian ProvinceChina Department of Radiology The Hospital of ChangleFuzhou 350200Fujian ProvinceChina

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies with high mortality and short survival *** tomography(CT)plays an important role in the diagnosis,staging and treatment of pancreatic *** cancer generally shows a low enhancement pattern compared with normal pancreatic *** To analyse whether preoperative enhanced CT could be used to predict postoperative overall survival in patients with *** Sixty-seven patients with PDAC undergoing pancreatic resection were enrolled *** patients underwent preoperative unenhanced and enhanced CT examination,the CT values of which were *** ratio of the preoperative CT value increase from the nonenhancement phase to the portal venous phase between pancreatic tumour and normal pancreatic tissue was *** cut-off value of ratios was obtained by the receiver operating characteristic(ROC)curve of the tumour relative enhancement ratio(TRER),according to which patients were divided into low-and high-enhancement *** and multivariate analyses were performed using Cox regression based on TRER ***,the correlation between TRER and clinicopathological characteristics was *** The area under the curve of the ROC curve was 0.768(P0.7 was defined as the high-enhancement *** to the TRER grouping,the Kaplan-Meier survival curve analysis results showed that the median survival(10.0 mo)with TRER≤0.7 was significantly shorter than that(22.0 mo)with TRER>0.7(P0.7(P<0.05).Our results demonstrated that patients in the low TRER group were more likely to have higher American Joint Committee on Cancer stage,tumour stage and lymph no

关键词： Pancreatic cancer Computed tomography Diagnostic imaging Kaplan-Meier curve Prognosis survival analysis

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