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Innovative analysis of predictors for overall survival from systemic non-Hodgkin T cell lymphoma using quantile regression analysis

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Chinese Medical Journal 2019年第3期132卷 294-301页

作者： Da-Yong Huang Yi-Fei Hu Na Wei Li Fu Lin Wu Jing Shen Jing-Shi Wang Zhao Wang Department of Hematology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Child Adolescent and Maternal HealthSchool of Public HealthCapital Medical UniversityBeijing 100069China

Background:Non-Hodgkin T/NK cell lymphoma is a rare and widely variable type of lymphoma with the most dismal prognosis. This study aimed to investigate varied impact of the clinical indicators to the overall survival (OS).Methods:We conducted a retrospective study to identify the non-invasive clinical features of T cell lymphoma that can predict prognosis with an innovative analysis method using quantile regression. A total of 183 patients who visited a top-tier hospital in Beijing, China, were enrolled from January 2006 to December 2015. Demographic information and main clinical indicators were collected including age, erythrocyte sedimentation rate (ESR), survival status, and international prognostic index (IPI) score.Results:The median age of the patients at diagnosis was 45 years. Approximately 80% of patients were at an advanced stage, and the median survival time after diagnosis was 5.1 months. Multivariable analysis of the prognostic factors for inferior OS associated with advanced clinical staging [HR=3.16, 95%CI (1.39-7.2)], lower platelet count [HR=2.57, 95%CI (1.57-4.19), P<0.001] and higher IPI score [HR=1.29, 95%CI (1.01-1.66), P=0.043]. Meanwhile, T cell lymphoblastic lymphoma [HR=0.40, 95%CI (0.20-0.80), P=0.010], higher white blood cell counts [HR=0.57, 95%CI (0.34-0.96), P=0.033], higher serum albumin level [HR=0.6, 95%CI (0.37-0.97), P=0.039], and higher ESR [HR=0.53, 95%CI (0.33-0.87), P=0.011] were protective factors for OS when stratified by hemophagocytic lymphohistiocytosis (HLH). Multivariable quantile regression between the OS rate and each predictor at quartiles 0.25, 0.5, 0.75, and 0.95 showed that the coefficients of serum β2-microglobulin level and serum ESR were statistically significant in the middle of the coefficient curve (quartile 0.25-0.75). The coefficient of IPI was negatively associated with OS. The coefficients of hematopoietic stem cell transplantation (HSCT) and no clinical symptoms were higher at the middle of the quartile level curve but were not statistically signific

关键词： Systemic non-Hodgkin T cell lymphoma overall survival Quantile regression analysis

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Prediction of overall survival following colorectal cancer surgery in elderly patients

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World Journal of Gastrointestinal Surgery 2019年第5期11卷 247-260页

作者： Isaac Seow-En Winson Jianhong Tan Sreemanee Raaj Dorajoo Sharon Hui Ling Soh Yi Chye Law Soo Yeun Park Gyu-Seok Choi Wah Siew Tan Choong Leong Tang Min Hoe Chew Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Department of General Surgery Sengkang General HospitalSingapore 544886Singapore Department of Pharmacy National University of SingaporeSingapore 117559Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Colorectal Cancer Center Kyungpook National University Chilgok HospitalKyungpook National University School of MedicineDaegu 702-210South Korea

BACKGROUND With advanced age and chronic illness,the life expectancy of a patient with colorectal cancer(CRC)becomes less dependent on the malignant disease and more on their pre-morbid condition.Justifying major surgery for these elderly patients can be challenging.An accurate tool demonstrating post-operative survival probability would be useful for surgeons and their patients.AIM To integrate clinically significant prognostic factors relevant to elective colorectal surgery in the elderly into a validated pre-operative scoring system.METHODS In this retrospective cohort study,patients aged 70 and above who underwent surgery for CRC at Singapore General Hospital between 1 January 2005 and 31 December 2012 were identified from a prospectively maintained database.Patients with evidence of metastatic disease,and those who underwent emergency surgery or had surgery for benign colorectal conditions were excluded from the analysis.The primary outcome was overall 3-year overall survival(OS)following surgery.A multivariate model predicting survival was derived and validated against an equivalent external surgical cohort from Kyungpook National University Chilgok Hospital,South Korea.Statistical analyses were performed using Stata/MP Version 15.1.RESULTS A total of 1267 patients were identified for analysis.The median post-operative length of stay was 8[interquartile range(IQR)6-12]d and median follow-up duration was 47(IQR 19-75)mo.Median OS was 78(IQR 65-85)mo.Following multivariate analysis,the factors significant for predicting overall mortality were serum albumin<35 g/dL,serum carcinoembryonic antigen≥20μg/L,T stage 3 or 4,moderate tumor cell differentiation or worse,mucinous histology,rectal tumors,and pre-existing chronic obstructive lung disease.Advanced age alone was not found to be significant.The Korean cohort consisted of 910 patients.The Singapore cohort exhibited a poorer OS,likely due to a higher proportion of advanced cancers.Despite the clinicopathologic differences,there was successful validation of the

关键词： Colorectal cancer surgery Elderly overall survival Pre-operative prognostic score

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Prolonged progression-free survival and overall survival are associated with diabetes mellitus but inversely associated with levels of blood glucose in patients with lung cancer

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Chinese Medical Journal 2020年第7期133卷 786-791页

作者： Ning-Fang Wang Hong-Mei Tang Fang-Lei Liu Qun-Ying Hong Department of Pulmonary Medicine Zhongshan HospitalFudan UniversityShanghai 200032China

Background:Previous studies have provided conflicting evidence about the increased overall survival(OS)in lung cancer patients with diabetes mellitus(DM)compared with those without DM.This study assessed progression-free survival(PFS)/OS in lung cancer patients with or without DM and tentatively analyzed the impact of blood glucose levels on PFS/OS in lung cancer patients.Methods:Data were collected from lung cancer patients based upon admission records from January 2010 to January 2012 and follow-up records from January 2010 to January 2015 in the Department of Pulmonary Medicine,Zhongshan Hospital,Fudan University,Shanghai.The data included patient sex,age,body mass index(BMI),smoking status,history of DM,level of blood glucose,pathological type,clinical stage of cancer,chemotherapy regimen,and history of anti-DM drugs.The Cox regression model and Kaplan-Meier method were used for the analysis of hazard factors and PFS/OS.For comparison of PFS/OS in lung cancer with or without DM,patients were divided into three groups:lung cancer with DM,lung cancer without DM but with elevated level of blood glucose,lung cancer without DM or elevated level of blood glucose.Results:In total,the data from 200 lung cancer patients(138 males/62 females,aged 29.0 to 78.0 years,mean 60.0±8.6 years)were collected.For the comparison of PFS/OS in lung cancer patients with or without DM,patients were divided into three groups:lung cancer with DM(n=31);lung cancer without DM but with elevated levels of blood glucose(n=40);and lung cancer without both DM and elevated levels of blood glucose(n=128),whereas 1 patient dropped out of the study.All the patients underwent complete chemotherapy and were followed up for 36.0 to 60.0 months.Kaplan-Meier survival analysis showed that lung cancer patients with DM had increased PFS and OS compared with those without DM(log-rank,P<0.05,P<0.01);the median PFS in lung cancer with DM was 12.0 months(95%confidence interval[CI],4.0-16.0)vs.6.0 months in those without DM(95%CI,5.8-6.3);and the median OS in

关键词： Diabetes mellitus Lung cancer overall survival Progression-free survival Serum glucose level

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Presence of serum antinuclear antibodies correlating unfavorable overall survival in patients with chronic lymphocytic leukemia

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Chinese Medical Journal 2019年第5期132卷 525-533页

作者： Qian Sun Li Wang Hua-Yuan Zhu Yi Miao Wei Wu Jin-Hua Liang Lei Cao Yi Xia Jia-Zhu Wu Yan Wang Rong Wang Lei Fan Wei Xu Jian-Yong Li Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing Jiangsu 210029 China Collaborative Innovation Center for Cancer Personalized Medicine Key Laboratory of Hematology Nanjing Medical University Nanjing Jiangsu 210029 China

Background: Serum antinuclear antibodies (ANAs) are positive in some patients with chronic lymphocytic leukemia (CLL), prognostic value of ANAs remains unknown. The aim of this study was to evaluate the role of ANAs as a prognostic factor in CLL. Methods: This study retrospectively analyzed clinical data from 216 newly diagnosed CLL subjects with ANAs test from 2007 to 2017. Multivariate Cox regression analyses were used to screen the independent prognostic factors related to time to first treatment (TTFT), progression free survival (PFS) and overall survival (OS). Receiver operator characteristic curves and area under the curve (AUC) were utilized to assess the predictive accuracy of ANAs together with other independent factors for OS. Results: The incidence of ANAs abnormality at diagnosis was 13.9%. ANAs positivity and TP53 disruption were independent prognostic indicators for OS. The AUC of positive ANAs together with TP53 disruption was 0.766 (95% confidence interval [CI]: 0.697-0.826), which was significantly larger than that of either TP53 disruption (AUC:0.706, 95% CI:0.634-0.772, P=0.034) or positive ANAs (AUC:0.595, 95% CI:0.520-0.668,P<0.001) in OS prediction. Besides, serum positive ANAs as one additional parameter to CLL-international prognostic index (IPI) obtained superior AUCs in predicting CLL OS than CLL-IPI alone. Conclusion: This study identified ANAs as an independent prognostic factor for CLL, and further investigations are needed to validate this finding.

关键词： Chronic lymphocytic leukemia Antinuclear antibody Autoimmunity Prognosis overall survival

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CD24 genetic variants contribute to overall survival inpatients with gastric cancer

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World Journal of Gastroenterology 2016年第7期22卷 2373-2382页

作者： Zhi-Fang Jia Li-Zhong Wang Xue-Yuan Cao Chuan Wang Dong-Hui Cao Xing Wu Li-Li You Mei-Shan Jin Yin-Ping Wang Bao-Sen Zhou Jing Jiang Division of Clinical Epidemiology First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Genetics University of Alabama at BirminghamBirminghamAL 35294United States Department of Gastrointestinal Surgery First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Division of Pathology First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Epidemiology School of Public HealthChina Medical UniversityShenyang 110112Liaoning ProvinceChina

AIM: To investigate the role of single nucleotide polymorphisms(SNPs) in CD24 gene in susceptibility and overall survival of gastric cancer(GC).METHODS: We genotyped 3 tagging SNPs of CD24-P-534 in the promoter region, P170 in the coding region of exon 2 and P1527 in the 3′ untranslated region- using polymerase chain reaction-restriction fragment length polymorphism in specimens from 679 histologically-confirmed GC cases, 111 gastric atrophy(GA) cases and 976 tumor-free controls. Serumimmunoglobulin G antibodies to Helicobacter pylori(H. pylori) of all subjects were detected by enzyme-linked immunosorbent assay. CD24 expression was evaluated by immunohistochemistry in 131 GC specimens. Correlations between SNPs and risk of GC or GA were shown by P values and odd ratios(ORs) with 95% confidence intervals(95%CI) compared with the most common genotype of each SNP using the unconditional logistic regression model after adjusting for age, sex and H. pylori infection. Survival within each SNP group was plotted by Kaplan-Meier method and compared by log-rank test(recessive model). Hazard ratios with 95%CIs were computed by Cox regression model after adjusting for age, sex, histological type, tumor differentiation, clinical stage and post-operational chemotherapy.RESULTS: All of the three loci were in Hardy-Weinberg equilibrium in the control group. Median followup time for the 600 GC patients included in the survival analysis was 36.2 mo(range, 2.1-66.7 mo; 95%CI: 34.3-36.5 mo). Patients with the P-534 A/A genotype had significantly shorter survival(HR = 1.38, 95%CI: 1.01-1.88, P = 0.042) than did the C/C or C/A genotype carriers after adjusting for age, sex, histological type, tumor differentiation, clinical stage and post-operational chemotherapy. This trend was more evident in patients who lived longer than 2.5 years(HR = 7.55, 95%CI: 2.16-26.32, P = 0.001). The P170 T/T genotype was associated with a shorter lifespan than the non-T/T genotypes, but not significantly so. None of the three genetic variants was found t

关键词： Gastric cancer CD24 Single nucleotidepolymorphisms Gastric atrophy overall survival

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overall Bi-directional Panoramic Exploration of the Solar System

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Aerospace China 2019年第2期20卷 46-52页

作者： WU Zhimin ZHAO Jincai Shanghai Academy of Spaceflight Technology Shanghai201108

An overall bi-directional panoramic solar system exploration activity,not just looking at the solar system at a macro level and helping to build a simulation model for the solar system,but the probe will also be able to explore the Milky Way and the vast universe from a much wider perspective.By observing the characteristics of the solar system,solar wind,ionization envelope and other parameters from a bi-directional panorama on both sides of the solar ecliptic plane,it will assist the scientific community and human kind to understand the solar system in a more extensive,deeper and systematic way than before.The exploration can be done in two steps.The first step is to launch a solar polar probe.Secondly to launch a bi-directional probe orbiting the galaxy in sync with the sun.

关键词： overall bi-directional panoramic exploration solar system

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overall Planning of Development and Security Accelerates Recovery in Global Post-Pandemic

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Peace 2021年第1期 57-58页

作者： Tao Jian University of International Relations

In the year 2020,the world seems to have pressed the button by mistake.A world-wide plague has profoundly changed the way of production,life,communication and even thinking of human society,which will inevitably have ... 详细信息

关键词： overall Development Security

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overall National Economy Maintained Stable in the First Two Months

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China's Foreign Trade 2019年第2期 40-41页

In the first two months of 2019,the economy performed within the reasonable range and maintained a generally stable and growing momentum;a positive trend has gradually been unveiled.The service industry grew steadily and the modern service industry developed fast In the first two months, the Index of Services Production increased by 7.3%year on year, maintaining the same speed as in December 2018.

关键词： overall National Economy Maintained Stable First Two Months

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Seven-senescence-associated gene signature predicts overall survival for Asian patients with hepatocellular carcinoma

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World Journal of Gastroenterology 2019年第14期25卷 1715-1728页

作者： Xiao-Hong Xiang Li Yang Xing Zhang Xiao-Hua Ma Run-Chen Miao Jing-Xian Gu Yu-Nong Fu Qing Yao Jing-Yao Zhang Chang Liu Ting Lin Kai Qu Department of Hepatobiliary Surgery the First Affiliated Hospital of Xi'an Jiaotong University Department of Clinical Laboratory Liaocheng People's Hospital Taishan Medical College

BACKGROUND Cellular senescence is a recognized barrier for progression of chronic liver diseases to hepatocellular carcinoma(HCC). The expression of a cluster of genes is altered in response to environmental factors during senescence. However, it is questionable whether these genes could serve as biomarkers for HCC patients.AIM To develop a signature of senescence-associated genes(SAGs) that predicts patients' overall survival(OS) to improve prognosis prediction of HCC.METHODS SAGs were identified using two senescent cell models. Univariate COX regression analysis was performed to screen the candidate genes significantly associated with OS of HCC in a discovery cohort(GSE14520) for the least absolute shrinkage and selection operator modelling. Prognostic value of this seven-gene signature was evaluated using two independent cohorts retrieved from the GEO(GSE14520) and the Cancer Genome Atlas datasets, respectively.Time-dependent receiver operating characteristic(ROC) curve analysis was conducted to compare the predictive accuracy of the seven-SAG signature and serum α-fetoprotein(AFP).RESULTS A total of 42 SAGs were screened and seven of them, including KIF18 B, CEP55,CIT, MCM7, CDC45, EZH2, and MCM5, were used to construct a prognostic formula. All seven genes were significantly downregulated in senescent cells andupregulated in HCC tissues. Survival analysis indicated that our seven-SAG signature was strongly associated with OS, especially in Asian populations, both in discovery and validation cohorts. Moreover, time-dependent ROC curve analysis suggested the seven-gene signature had a better predictive accuracy than serum AFP in predicting HCC patients' 1-, 3-, and 5-year OS.CONCLUSION We developed a seven-SAG signature, which could predict OS of Asian HCC patients. This risk model provides new clinical evidence for the accurate diagnosis and targeted treatment of HCC.

关键词： Senescence-associated genes Hepatocellular carcinoma overall survival Risk model Asian patients

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PIK3CA and TP53 mutations predict overall survival of stage Ⅱ/Ⅲ colorectal cancer patients

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World Journal of Gastroenterology 2018年第5期24卷 631-640页

作者： A-Jian Li Hua-Guang Li Er-Jiang Tang Wei Wu Ying Chen Hui-Hong Jiang Mou-Bin Lin Lu Yin Department of General Surgery Shanghai Tenth People’s Hospital Tongji University School of Medicine Center for Trans-lational Medicine Yangpu Hospital Tongji University School of Medicine Department of General Surgery Yangpu Hospital Tongji University School of Medicine

AIM To investigate the predictive value of PIK3 CA and TP53 mutation status in colorectal cancer(CRC) patients treated with 5-fluorouracil-based chemotherapy.METHODS In this study, a total of 315 patients with histologically proven CRC were enrolled from Yangpu Hospital affiliated to Shanghai Tongji University between 2007 and 2011. Of these patients, 241 with stage Ⅱ/Ⅲ CRC received 5-fluorouracil-based adjuvant chemotherapy. Formalin-fixed paraffin-embedded lesion samples of the patients with curatively resected CRC were collected.Next-generation sequencing was performed to identify somatic gene mutations. The correlation of PIK3 CA and TP53 mutation status with overall survival(OS) was analyzed using a Cox proportional hazard model and the Kaplan-Meier method.RESULTS Among the 241 patients with stage Ⅱ/Ⅲ in this cohort, the PIK3 CA and/or TP53 mutation was detected in 177 patients, among which 54 patients had PIK3 CA and TP53 double mutations. The PIK3 CA or TP53 mutation was not significantly correlated with OS in univariate and multivariate analyses. Compared with patients without PIK3 CA and TP53 mutations, those with double PIK3 CA-TP53 mutations showed a significantly worse survival(univariate HR = 2.21; 95%CI: 1.15-4.24; multivariate HR = 2.02; 95%CI: 1.04-3.91). The PIK3 CA mutation located in the kinase domain showed a trend toward a shorter OS compared with wild-type tumors(multivariate HR = 1.56; 95%CI: 1.00-2.44; P = 0.052). The Kaplan-Meier curve showed that patients harboring the PIK3 CA mutation located in the kinase domain had a worse clinical outcome than those with wild-type status(Log-rank P = 0.041)CONCLUSION Double mutation of PIK3 CA and TP53 is correlated with a shorter OS in stage Ⅱ/Ⅲ CRC patients treated with 5-fluorouracil-based therapy.

关键词： overall survival Colorectal cancer PIK3CA TP53 5-fluorouracil Double mutation

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