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Post-transplantation hepatocellular carcinoma recurrence: Patterns and relation between vascularity and differentiation degree

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World Journal of Hepatology 2015年第2期7卷 276-284页

作者： Annarita Pecchi Giulia Besutti Mario De Santis Cinzia Del Giovane Sofia Nosseir Giuseppe Tarantino Fabrizio di Benedetto Pietro Torricelli dipartimento di diagnostica per Immagini Azienda Ospedaliero-Universitaria Policlinico di Modena Unità di Statistica Medica Dipartimento di Medicina Diagnostica Clinica e Sanità Pubblica Università di Modena e Reggio Emilia dipartimento dei Laboratori Anatomia Patologica e Medicina Legale Università degli studi di Modena e Reggio Emilia dipartimento Chirurgico Medico Odontoiatrico e di Scienze Morfologiche con interesse Trapiantologico Oncologico e di Medicina Rigenerativa Università di Modena e Reggio Emilia

AIM: To evaluate the relationship between hepatocellular carcinoma(HCC) vascularity and grade; to describe patterns and vascular/histopathological variations of post-transplantation recurrence.METHODS: This retrospective study included 165 patients(143 men, 22 women; median age 56.8 years, range 28-70.4 years) transplanted for HCC who had a follow-up period longer than 2 mo. Pre-transplantation dynamic computed tomography or magnetic resonance examinations were retrospectively reviewed, classifying HCC imaging enhancement pattern into hypervascular and hypovascular based on presence of wash-in during arterial phase. All pathologic reports of the explanted livers were reviewed, collecting data about HCC differentiation degree. The association between imaging vascular pattern and pathological grade was estimated using the Fisher exact test. All follow-up clinical and imaging data were reviewed for evidence of recurrence. Recurrence rate was calculated and imaging features of recurrent tumor were collected, classifying early and late recurrences based on timing(differentiation degree was collected where available. The presence of variations in imaging enhancement pattern and pathological grade between the primary tumor and the intrahepatic recurrence was evaluated and the association between imaging and histopatholgical variations was estimated by using the χ2 test. RESULTS: Of the 163 patients with imaging evidence of viable tumor, 156(95.7%) had hypervascular and 7(4.3%) hypovascular HCC. Among the 125 patients with evidence of viable tumor in the explanted liver, 19(15.2%) had grade 1, 56(44.8%) grade 2, 40(32%) grade 3 and 4(3.2%) grade 4 HCC, while the differentiation degree was not assessable for 6 patients(4.8%). A significant association was found between imaging vascularity and pathologi

关键词： Contrast media Hepatocellular carcinoma Liver transplantation Cell differentiation Recurrence

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How to impute study-specific standard deviations in metaanalyses of skewed continuous endpoints?

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World Journal of Meta-Analysis 2015年第5期3卷 215-224页

作者： Teresa Greco Giuseppe Biondi-Zoccai Marco Gemma Claude Guérin Alberto Zangrillo Giovanni Landoni Laboratorio di statistica medica Biometria ed Epidemiologia "G.A.Maccacaro" Dipartimento di Scienze Cliniche e di Comunità University of Milan Anaesthesia and Intensive Care Department IRCCS San Raffaele Scientific Institute Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of Rome Eleonora Lorillard Spencer Cenci Foundation Meta-analysis and Evidence Based Medicine Training in Cardiology (METCARdiO) medical Intensive Care Hospital de La Croix Rousse

AIM: To compare four methods to approximate mean and standard deviation(SD) when only medians and interquartile ranges are provided.METHODS: We performed simulated meta-analyses on six datasets of 15, 30, 50, 100, 500, and 1000 trials, respectively. Subjects were iteratively generated from one of the following seven scenarios: five theoretical continuous distributions [Normal, Normal(0, 1), Gamma, Exponential, and Bimodal] and two real-life distributions of intensive care unit stay and hospital stay. For each simulation, we calculated the pooled estimates assembling the study-specific medians and SD approximations: Conservative SD, less conservative SD, mean SD, or interquartile range. We provided a graphical evaluation of the standardized differences.To show which imputation method produced the best estimate, we ranked those differences and calculated the rate at which each estimate appeared as the best, second-best, third-best, or fourth-best.RESULTS: Our results demonstrated that the best pooled estimate for the overall mean and SD was provided by the median and interquartile range(mean standardized estimates: 4.5 ± 2.2, P = 0.14) or by the median and the SD conservative estimate(mean standardized estimates: 4.5 ± 3.5, P = 0.13). The less conservative approximation of SD appeared to be the worst method, exhibiting a significant difference from the reference method at the 90% confidence level. The method that ranked first most frequently is the interquartile range method(23/42 = 55%), particularly when data were generated according to the Standard Normal, Gamma, and Exponential distributions. The second-best is the conservative SD method(15/42 = 36%), particularly for data from a bimodal distribution and for the intensive care unit stay variable. CONCLUSION: Meta-analytic estimates are not significantly affected by approximating the missing values of mean and SD with the correspondent values for median and interquartile range.

关键词：英文文摘荟萃杂志

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