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At least 343 records · Page 19Linked to original sources
PubMed1990

Transcranial electrical motor evoked potentials as a prognostic indicator for motor recovery in stroke patients.

Transcranial electrical motor evoked potentials (MEP) were examined in 33 patients within three days after stroke. Normal values for MEP and motor central conduction time (CCT) were obtained in 46 healthy controls whose MEPs were evaluated during slight voluntary muscle contraction and at rest. Two months later 23 patients were re-examined clinically and electrophysiologically. Motor function change was correlated with MEP results. Two months after stroke the patients with normal or prolonged CCT had an improved motor function compared with those with absent CCT. MEP may be a valuable prognostic indicator in the acute stage of paralytic stroke for recovery of motor function.

Adult↗
PubMed1993

Colles' fractures: the use of the metacarpal index as a prognostic indicator investigated.

The radiographs of 25 patients who presented to the Whittington Hospital with Colles' fractures were studied. Measurements of dorsal angulation and radial shortening were made on radiographs taken at presentation, following reduction (where performed) and 5 weeks after injury. The presence, and degree, of osteoporosis was assessed using the metacarpal index. There was a strong correlation between the degree of osteoporosis and age. There was no correlation between the degree of osteoporosis, as determined by the metacarpal index, and either the severity of the injury or the final result. Thus, the metacarpal index is not a useful prognostic indicator as to the radiological outcome of Colles' fractures. The single most important factor influencing the radiological result was the quality of the initial reduction.

Adult↗
PubMed1993

Prognostic indicators in early breast cancer.

Approximately 115,000 new cases of axillary node negative breast cancer were diagnosed in this country last year. Since about 20-30% of these patients will ultimately relapse and die of their disease, adjuvant systemic therapy has been advocated for this group to decrease the relapse rate and prolong survival. However, although most clinical trials have demonstrated a modest impact on disease recurrence, the available data have failed to show consistent improvements in overall survival and does not justify the generalized use of systemic treatment in this patient subgroup. For this reason, a plethora of prognostic factors have been described to identify those patients with a higher risk of recurrence to concentrate therapeutic options in this specific group. Of all the disease prognosticators studied, tumor size, nuclear grade, and proliferative indexes appear to correlate well with tumor recurrence. In addition, biologic characteristics of primary tumors such as the presence of hormone and growth factor receptors, secretion of specific polypeptides and proteases, expression of proto-oncogenes, and abnormalities in tumor suppressor genes have been shown to be potentially useful as prognostic indicators in patients with early breast cancer. Despite these provocative data, larger clinical trials are necessary before incorporating these parameters in the routine evaluation of patients with axillary node negative breast cancer.

Breast Neoplasms↗
PubMed2001

Early diagnostic and prognostic indicators in full term infants with neonatal cerebral infarction: an integrated clinical, neuroradiological and EEG approach.

In the last decade the increase in neonatal imaging in infants with abnormal neurological signs has highlighted the incidence and the wide spectrum of neonatal cerebral infarction. These lesions occur in 1 in 4000 full term infants and are often associated with convulsions in the first days after birth. This review will cover new knowledge on aetiology and classification of these lesions. Special attention will be paid to the value of an integrated approach, using clinical, EEG and neuroimaging tools as early diagnostic and prognostic indicators of outcome.

Cerebral Infarction↗
PubMed1989

Relative importance of estrogen and progesterone receptor assays as prognostic indicators in primary breast cancer: a short-term study.

This short-term study of the relative importance of estrogen and progesterone receptors shows that progesterone receptor correlates better than estrogen receptor with tumor recurrence regardless of lymph-node status. Life-table analysis has effectively identified only two groups of patients that may be classified by progesterone receptor status alone. Progesterone-receptor negativity correlated well with tumors of histological Grade III; estrogen-receptor positivity correlated with Grade I and II tumors. The earlier recurrence of Grade III breast tumors may explain why progesterone receptor is a better prognostic indicator than estrogen receptor in short-term studies.

Breast Neoplasms↗
PubMed1987

Colorectal cancer: Lahey Clinic experience, 1972-1976. An analysis of prognostic indicators.

The records of 344 consecutive patients with colorectal cancer treated operatively at the Lahey Clinic from 1972 through 1976 were reviewed, and the effects of 41 clinical and pathologic variables on survival were analyzed. The variables associated with poorer five-year survival rates were advanced Dukes' stage, four or more positive nodes, blood vessel invasion, lymphatic invasion, circumferential involvement, and obstruction at initial presentation. As a group, patients with right colon cancers (cecum and ascending colon) had the best survival rates. When fistula formation or localized perforation had occurred, en bloc resection of locally involved adjacent viscera improved survival rates. These prognostic indicators aid in the selection of patients for wider colonic and mesenteric resections.

Actuarial Analysis↗
PubMed2001

Illegitimate switch recombinations are present in approximately half of primary myeloma tumors, but do not relate to known prognostic indicators or survival.

The myeloma plasma cell is a postgerminal center, isotype-switched B cell. Chromosomal translocations into immunoglobulin heavy chain (IgH) switch regions, recombination sites in isotype switching, were initially demonstrated in myeloma cell lines but only a limited number of primary tumors. Molecular cytogenetics have since been applied to a series of primary tumors, in which IgH translocations accounted for many recurrent aberrations, among numerous nonrecurrent changes of unknown significance. This study, therefore, examined primary myeloma for IgH switch translocations using an established Southern blot assay that detected illegitimate switch recombinations. Sensitivity of the method was established by confining the analysis to 21 samples (4 stable, 17 progressive disease) with demonstrable legitimate isotype switches, of a total of 60 samples. Illegitimate recombinations were found in 12 or 57% (1 stable, 11 progressive) of 21 samples, comparable with estimates by molecular cytogenetics. The presence of switch translocations was supported by demonstrating up-regulated expression in myeloma marrow of cyclin D1 and fibroblast growth factor receptor 3 (FGFR3), candidate oncogenes on chromosomes 11q13 and 4p16, respectively. Illegitimate switches were detected most frequently in Smu, with more than one region involved in 6 cases. Although these results confirmed the presence of switch translocations in primary myeloma, their absence in 43% of cases may imply heterogeneity of pathogenesis. In progressive disease, there was no significant difference between patients with and without illegitimate switches in survival, nor the prognostic indicators of beta(2) microglobulin (beta(2)m) and serum thymidine kinase (STK). Hence IgH switch translocations as a single entity are unlikely to be a feature of disease progression or have prognostic significance.

Adult↗
PubMed1997

Is the expression of multidrug resistance gene product a prognostic indicator for the clinical outcome of patients with renal cancer?

OBJECTIVE: To determine the significance of the expression of the multidrug resistance gene product (MDR-1) for the aggressiveness of renal cell carcinoma (RCC). PATIENTS AND METHODS: The study comprised 31 patients with clinically locally confined RCC treated with radical nephrectomy (mean age 64.1 years, range 41-78; mean follow-up 5.4 years, range 4.3-7.3). Their survival time and disease-free period were evaluated retrospectively. The expression of the MDR-1 gene product was determined immunohistochemically using the JSB-1 antibody in formalin-fixed paraffin-embedded tumour samples from these patients. The significance of this variable and tumour stage and malignancy grade was assessed for predicting the survival and disease-free period using Kaplan-Meier plots (log-rank test or Tarone's test) and the Cox multiple hazard regression analysis. RESULTS: In a univariate analysis, tumour stage (P < 0.002), malignancy grade (P < 0.007) and MDR-1 (P < 0.03) were significant prognostic variables for both survival and disease-free period. Lower MDR-1 expression was correlated with poorer prognosis. On multivariate analysis, MDR-1 and tumour stage were significant factors for predicting the disease-free period, whereas tumour stage and malignancy grade were the most relevant factors for survival time. Calculating prognostic indices based on the results of the Cox analysis, MDR-1 could replace malignancy grade, resulting in a better prediction of survival and disease-free period (P < 0.001 vs 0.0031, P < 0.001 vs 0.021, respectively). CONCLUSION: MDR-1, an established predictor for chemo-resistance, may also be a potent prognostic factor for outcome in patients with locally confined RCC. Moreover, MDR-1 expression seems to correlate with the differentiation of the RCC and thus its value as an objective measure of the degree of differentiation should be further explored.

Adult↗
PubMed1994

Quantitative immunocytochemical assays of P-glycoprotein in breast carcinomas: correlation to messenger RNA expression and to immunohistochemical prognostic indicators.

BACKGROUND: Chemotherapy failure that is due to cellular drug resistance remains a major problem in most cancer patients. One type of drug resistance that has been characterized is the multidrug resistance phenomenon, which demonstrates a reduced ability of cancer cells to accumulate drugs as a result of the effects of an energy-dependent unidirectional drug efflux pump with a broad substrate specificity. This drug pump is composed of a 170-kd transmembrane glycoprotein referred to as the P-glycoprotein (P-gp) that uses energy in the form of adenosine triphosphate to transport drugs through a channel formed by transmembrane segments. PURPOSE: Our purpose was to detect the levels of P-gp expression in frozen untreated breast carcinomas by immunocytochemical assays and to correlate these levels to current prognostic indicators and, in a few cases, to MDR1 (also known as PGY1) mRNA expression by polymerase chain reaction (PCR). METHODS: The immunocytochemical expression of the multidrug resistance gene, P-gp, was investigated using a specific monoclonal antibody (JSB1) against P-gp in 5-microns frozen sequential sections of breast carcinomas obtained from 213 patients. Microscopic images of immunostained preparations were evaluated by image analysis and were compared with MDR1 transcription (mRNA) assessed by PCR in 16 patients. Quantitative P-gp immunocytochemical assays were correlated to histoprognostic factors and immunocytochemical indicators. RESULTS: Among the 213 breast carcinomas tested, 113 (53%) were P-gp positive, but in 28% of the tumors, the immunostained surface accounted for less than 5% of the total area stained. Quantitative immunocytochemistry reflecting the amount of intracellular P-gp antigen strongly correlated (r = 0.865; two-sided, P < .0001; Pearson's test) with the quantitative evaluation of the scanner analysis of mRNA transcripts. The P-gp expression was significantly (two-sided, P < .001) correlated with p53 expression in tumors, to cathepsin D and Ki67 (two-sided, P < .01) immunoreactivity, and to a lesser extent, the detection of estrogen receptor antigenic sites (two-sided, P = .019). P-gp expression was found to be independent of expression of progesterone receptor and pS2, pHER-2/neu, and CD31 in tumors and from patient age, tumor size, histologic types, grades and Nottingham prognostic index, and nodal status. CONCLUSIONS: The quantitative immunocytochemical assays of P-gp are correlated to PCR analysis of MDR1 expression, and such correlations can be useful in evaluating potential multidrug resistance in breast cancer. However, the clinical significance of P-gp immunodetections remains to be further determined.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1993

Cell proliferation as a prognostic indicator in conjunctival malignant melanoma.

Expression of proliferating cell nuclear antigen, a DNA polymerase delta auxiliary protein, was studied in 20 specimens from 20 patients with conjunctival malignant melanoma by means of the total number of cells that showed immunoreactivity per square millimeter. The countings were shown to be reproducible with minimal intraobserver variability. In a multifactor analysis of variance (ANOVA) that adjusted for possible confounders, patients who subsequently died of metastatic disease had significantly higher counts of cells that were positive for proliferating cell nuclear antigen per square millimeter (P = .0011) than patients with a minimum survival of five years without clinical signs of metastatic disease. A multivariate Cox regression model confirmed the independent prognostic value (P = .048) of the cell counts. Individual hazard ratios were estimated in a final Cox model and two groups of patients with low and high hazard ratios were formed. Five-year cumulated survival proportions of the two groups were 90% and 60%, respectively. The total count of cells displaying immunoreactivity for proliferating cell nuclear antigen per square millimeter may be used as a prognostic indicator in patients with conjunctival melanoma.

Analysis of Variance↗
PubMed1994

Circulating levels of colony-stimulating factor 1 as a prognostic indicator in 82 patients with epithelial ovarian cancer.

Serum samples from 82 patients with epithelial ovarian cancer, previously assayed for CA125, were assayed for circulating colony-stimulating factor 1 (CSF-1). An elevated CSF-1 concentration (> 450 U ml-1 or > 5.42 ng ml-1) was significantly associated with a worse survival (P = 0.02). The predictive value of raised CSF-1 levels was retained whether the first available sample for all patients (n = 82) or the first sample at the start of chemotherapy (n = 41) was considered. Mean CSF-1 levels (n = 14) dropped significantly during six courses of platinum-based chemotherapy (P = 0.02). Although an elevated CA125 concentration appeared to be a prognostic indicator in the total population (n = 82), it was not related to prognosis in the group of patients from whom samples had been drawn at the start of chemotherapy. In a Cox proportional hazards model, CSF-1, but not CA125, was significantly associated with outcome following adjustment for stage, grade and degree of surgical clearance.

Adenocarcinoma↗
PubMed2002

Immunohistochemical prognostic indicators of gastrointestinal carcinoid tumours.

AIMS: The aim of this study was to determine whether expression of the oncoproteins p21, p53, E-cadherin (EC), cyclin D1, bcl-2 and Rb and the proliferation marker Ki-67 is predictive of malignant behaviour in gastrointestinal carcinoid tumours. METHODS: Immunohistochemical (IHC) staining was performed on carcinoid tumours from 41 patients (31 rectal, eight gastrointestinal, two appendiceal lesions). The six tumours that had invaded deeply into the muscularis propria or beyond, had metastasized to regional lymph nodes or had metastasized to a distant site were classified as the malignant group, and the other 35 tumours formed the benign group. IHC expression was compared between the two groups, and the prognostic value of each marker was assessed. RESULTS: Of the six tumours in the malignant group, 66.7% were p21 positive, 0% were p53 positive, 33.3% were EC positive, 100% were cyclin D1 positive, 33.3% were Rb positive, 16.7% were bcl-2 positive and 50% were Ki-67 positive. Of the 35 tumours in the benign group, 17.1% were p21 positive, 0% were p53 positive, 100% were EC positive, 94.3% were cyclin D1 positive, 8.6% were Rb positive, 17.1% were bcl-2 positive and 0% were Ki-67 positive. CONCLUSIONS: These data show that p53, cyclin D1, Rb, bcl-2 and Ki-67 staining does not correlate with malignant behaviour but that overexpression of p21 (P=0.02) and reduced staining of EC (P=0.005) do correlate with malignant behaviour. These two parameters may therefore be useful as prognostic indicators for gastrointestinal carcinoid tumours.

Adult↗
PubMed1984

Reduced graft-versus-host reaction of T cells in Kaposi's sarcoma: a possible prognostic indicator.

In 20 patients with Kaposi's sarcoma (KS) the level of B and T lymphocytes in the peripheral blood, as well as the function of T cells measured by the graft-versus-host reaction (GVHR), were investigated. Analysis of the results regarding the distribution of skin lesions showed that the mean GVHR was within normal range in 13 patients in whom the lesions were confined to the distal portions of the extremities. In 7 patients, who demonstrated generalized distribution of the eruption, the mean GVHR was significantly lower in comparison with the control group. In view of our results we may conclude that cellular immunity is impaired in KS patients with generalized distribution. Testing T cell function is recommended as a possible prognostic indicator.

Adult↗
PubMed1978

The syndromes of familial atrioventricular block with sinus bradycardia: prognostic indices, electrophysiologic and histopathologic correlates.

A family with adult onset heart block (AOHB) and sinus bradycardia (SB) was investigated 5 yr after previous study. A 44-yr-old female previously 'normal' presented ECG evidence of 1st-degree and 2nd-degree atrioventricular block (AVB) with normal intraventricular conduction and episodic 3rd-degree AVB. His bundle electrocardiography (HBE) demonstrated A--H prolongation (245msec) with normal H--V time during sinus rhythm and 3rd-degree AV nodal block with a His bundle escape rhythm. Sinus node function served in first-order relatives. HBE and sinus node function were normal in a 38-yr-old sister with new SB. 37 families with familial 3rd-degree AVB were reviewed with attention to prognostic indices and electrophysiologic-pathologic correlates. The incidence of conduction abnormalities supported an autosomal dominant transmission with variable penetrance. Subsidiary pacemaker rate and QRS morphology showed no discriminative value with respect to prognosis. HBS identified A--H prolongation in 2 patients with AOHB and 2 with AOHB and SB, with coexistent H--V conduction delay in 2 cases of AOHB and SB with abnormal QRS morphology. Histopathology was variable, but the finding of multiple lesions in 2 of 5 patients with congenital heart block and each of 2 with AOHB and SB suggests that mixed conduction system disease is prevalent in familial heart block.

Adult↗
PubMed1989

Prognostic indicators of survival in patients with cirrhosis and esophageal varices, without previous bleeding.

Sixty-one patients with cirrhosis with varices without previous bleeding were admitted to our Department over a period of 2 yr. Fifty had alcoholic cirrhosis. Child-Turcotte-Pugh class was A in 11 patients, B in 30, and C in 20. Varices were F1 in 18, and F2-F3 in 43. During follow-up of up to 40 months, one patient was lost to follow-up and 22 patients died, seven of gastrointestinal bleeding and 15 of liver failure. The probability of death from any cause was significantly related to Child-Turcotte-Pugh class, ascites, encephalopathy, s-albumin, s-bilirubin, prothrombin index, and galactose elimination capacity. Independent prognostic variables according to Cox's model resulted s-albumin, s-bilirubin, encephalopathy, and varices. Considering only patients who died from liver failure, survival was univariately related to the same determinants, whereas the Cox's model individuated s-bilirubin, s-albumin, ascites, and galactose elimination capacity as independent prognostic indicators. Considering only patients who died from gastrointestinal bleeding no Cox model could be performed due to the small number of deaths. In patients with F1 varices, the probability of death from liver failure was 5 times higher than that from gastrointestinal bleeding; in patients with F2-F3 varices, liver failure and gastrointestinal bleeding each accounted for approximately half of the deaths. These data could become useful when programming a clinical trial of prophylaxis which considers reduction in mortality as the main end-point.

Adult↗
PubMedDate not supplied

Tumor angiogenesis as an independent prognostic indicator in human papillary thyroid carcinoma.

Angiogenesis has been determined to play a very important role in either the growth of solid tumors or their recurrence in distant organs. Microvessels stained immunohistochemically for the factor VIII-related antigen were counted in one hundred patients with papillary thyroid carcinoma in order to clarify the association of tumor angiogenesis with the prognosis of the disease. The mean microvessel count (MVC) was significantly higher in tumors with distant recurrence than those without recurrence. Disease-free survival of patients with a high MVC (>/= 23) was significantly worse than that of patients with a low MVC (</= 22), as well as the overall survival. In multivariate analysis, the MVC was most strongly correlated with disease-free survival, and was independent of other prognostic factors. In conclusion, the MVC is a potent prognostic indicator in papillary thyroid carcinoma.

Adolescent↗
PubMed1983

Cloning efficiency. A possible prognostic indicator in squamous cell carcinoma of the head and neck.

Seventy-three squamous cell carcinomas arising in the head and neck region were cultured using the soft agar clonogenic system. Thirty-six (49%) demonstrated clonal growth. The cloning efficiency was variable, ranging from 0.001% to 1.67% (median, 0.004%). Statistically significant correlations of high cloning efficiency with advanced local class, increased stage, and decreased survival were observed. There was no correlation between cloning efficiency and T-class or modified Jakobsson's histologic grade. A cloning efficiency of greater than or equal to 0.005% was associated with a high likelihood of death from disease or the development of recurrent disease. For head and neck squamous cell carcinomas, the cloning efficiency in soft agar appears to be a potentially useful prognostic indicator.

Carcinoma, Squamous Cell↗
PubMed1992

Prognostic indicators in prostatic cancer.

For therapeutic decisions it is essential to have an evaluation of the tumor volume and the grade of dedifferentiation. Measurement of PSA gives a good additional guide to the tumor volume and to dissemination of the disease. Investigation of the DNA ploidy values can offer further important information on the aggressiveness of the tumor and be helpful for our understanding of the process of tumor propagation. However, DNA studies can still not be regarded as being standard in the clinical work-up of these patients. They are optional but they have a definite place in the research on prostatic cancer. The various methods to study tumor growth by analysis of the S phase fraction are interesting new contributions but still belong to the research laboratories. When we consider prognostic indicators we have to take into account the biologic character of carcinogenesis. Modern research has shown that the development and the progression of cancer is not an instantaneous and solitary reaction. It is a series of events and a net-work reaction between growth-regulating factors, stimulating and inhibiting, a step-wise alteration of the genome. We must recognize that what we are observing is the condition at the present time, and, of course, the observation must be evaluated together with the whole clinical scenario, the man's age, his general condition etc. But still the series of diagnostic procedures presented here will give a rather solid ground for both our therapeutic decisions and for evaluation of the results of treatment.

Biomarkers, Tumor↗