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PubMed1999

The a- and b-wave latencies as a prognostic indicator of neovascularisation in central retinal vein occlusion.

To evaluate the prognostic value of ERG in cases of central retinal vein occlusion (CRVO) regarding the development of neovascularisation (NV), we studied 20 patients with unilateral CRVO. Half of them were allocated in the perfused group and the other 10 finally developed NV and were allocated in the non-perfused group. Flash ERG was recorded from all patients. Our findings suggest that b-wave latency is the most reliable parameter in predicting NV, followed by the a-wave latency. The b/a wave amplitude of ERG ratio does not seem to be suitable for clinical use.

Aged↗
PubMed2002

Circulating peripheral blood plasma cells as a prognostic indicator in patients with primary systemic amyloidosis.

This study examined the prognostic value of circulating peripheral blood plasma cells (PBPCs) in patients with primary systemic amyloidosis (AL). A sensitive slide-based immunofluorescence technique was used to assess 147 patients for circulating PBPCs. Circulating monoclonal plasma cells were quantified as a percentage of circulating cytoplasmic immunoglobulin-positive cells (PBPC%). The absolute circulating plasma cell count was also determined. When analyzed retrospectively, 24 (16%) of 147 patients were found to have detectable circulating PBPCs. Overall survival for patients with high PBPC%'s (> 1%) was poorer (median survival, 10 vs 29 months; P =.002). Similarly, overall survival for patients with high PBPC counts (> 0.5 x 10(6)/L) was significantly poorer (median, 13 vs 31 months; P =.003). Increased percentages of bone marrow plasma cells (BMPC%; P =.0004), increased levels of serum beta(2)-microglobulin (P =.04), and dominant cardiac amyloid involvement (P =.03) also predicted poorer survival. The combined consideration of circulating PBPCs and BMPC% identified low-, intermediate-, and high-risk groups with median survivals of 37.5, 15.5, and 10 months, respectively (P =.0003). Multivariate analysis revealed circulating PBPCs and BMPC% to be independent prognostic factors for survival. Patients with PBPC%'s of 2% or higher were significantly more likely to have a coexisting clinical diagnosis of multiple myeloma (50% vs 12%, P =.008). The prognostic value of circulating PBPCs may help select treatment for patients with AL.

Adult↗
PubMed2005

Residual complaints following lumbar disc surgery: prognostic indicators of outcome.

Physical as well as psychological features might be important prognostic factors for residual complaints following lumbar disc surgery in primary care. No studies have yet investigated both factors simultaneously. The aim of this prospective cohort study was to identify indicators of the short and long-term outcome of residual complaints following lumbar disc surgery. Patients (n=105), aged between 18 and 65 years, were included if they still suffered residual complaints 6 weeks after first-time lumbar disc surgery and had therefore been referred to physiotherapy. All potential indicators were measured at baseline except treatment expectancy, which was measured after two treatment sessions enabling patients to rate treatment expectancy based on their actual perception of the treatment. Dimensions of recovery included perceived recovery, functional status, and pain intensity (back and leg) at the 3-month and 12-month follow-up. It was found that high treatment expectancy was associated with a favorable outcome on perceived recovery and functional status, both at the 3 and the 12-month follow-up. Taking pain medication and a poor functional status at baseline were associated with poor perceived recovery and functional status at both follow-up measurements. Leg pain and back pain at baseline were associated with residual leg and back pain at the 3 and the 12-month follow-up, respectively. The results for perceived recovery and functional status were rather robust. However, for leg pain and back pain, the results were less stable. Apparently, the clinical course to recovery of residual leg pain and residual back pain is not strongly influenced by these indicators.

Adolescent↗
PubMed1999

Telomerase activity as a prognostic indicator in stage I non-small cell lung cancer.

Patients with stage I non-small cell lung cancer (NSCLC) are typically treated with surgical resection alone. However, about one-third of such patients develop disease recurrence and die within 5 years after complete resection. The ability to predict recurrence could represent an important contribution to treatment planning. This study evaluates the presence of telomerase activity in tumor cells as a predictor of disease recurrence and cancer-related death after operation for stage I NSCLC patients. The activity of the telomerase enzyme was investigated by telomeric repeat amplification protocol (TRAP) in tumors and matching normal lung tissue samples obtained from 107 consecutive operable patients with pathological stage I NSCLC. Telomerase activity was detected in 66 (62%) of the 107 tumors examined and in none of the corresponding adjacent noncancerous lung tissue samples. Correlation with pathological parameters showed that telomerase activity was associated with histopathological grade (P = 0.0135) but not with tumor size or histological type. Univariate survival curves, estimated using the method of Kaplan and Meier, defined a significant association between telomerase activity and both disease-free survival (P = 0.0115) and overall survival (P = 0.0129). In multivariate analyses, performed by Cox's proportional hazards regression models, the presence of telomerase activity was the only strong predictor of disease-free survival (P = 0.0173) and overall survival (P = 0.0187). Our data indicate that telomerase activity can be an important prognostic factor that should be considered in future prospective trials of adjuvant therapy for high-risk stage I NSCLC patients.

Adenocarcinoma↗
PubMed1979

[Prognostic indices in acute pancreatitis (author's transl)].

In a retrospective study 55 patients with acute pancreatitis were reviewed in order to establish the prognostic value of 11 indices which can be determined either at admission of 48 hours after the onset of the disease. The results show: 1. the 5 indices determined at admission (age, white blood cell count, blood glucose, SGOT, LDH) do not permit a clear identification of the variable courses of acute pancreatitis, 2. a high risk group can be selected; in this group an early intensive care is recommended, i.e. a vigorous fluid replacement, endotracheal intubation and assisted ventilation with PEEP, and, if necessary, peritoneal dialysis. Furthermore these indices are helpful to decide very early whether a patient has to be transmitted to a medical centre for intensive care and/or surgical treatment.

Acute Disease↗
PubMed1997

Leukocyte glucose 6 phosphate dehydrogenase as prognostic indicator in ANLL and CML.

Glucose 6 phosphate dehydrogenase (G6PD) was estimated in the leucocytes of 35 patients with acute non-lymphocytic leukemia (ANLL) and 10 patients with chronic myeloid leukemia (CML). G6PD levels were found to be significantly decreased in majority of the patients with ANLL while it was increased in all CML patients. Variation in G6PD was found to be dependent on the percentage of myelocytes inANLL. Cytogenetic analysis was also carried out in these patients. Correlation analysis of leucocyte G6PD activity and karyotype with prognostic assessment clearly indicated the association of (s) high percentage of chromosomal abnormalities especially translocations, (b) low survival and remission rates, with patients having decreased G6PD activity when compared to patients with normal activity in ANLL. The studies indicate that leucocyte G6PD may be useful as a diagnostic and prognostic tool.

Biomarkers, Tumor↗
PubMed2005

Prognostic indicators estimated by (99m)Tc-GSA in acute liver damage.

A prognostic estimation formula of acute liver damage was evaluated by using clinical data and technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin ((99m)Tc-GSA) scintigraphy in order to determine operability for orthotopic liver transplantation (OLT). Forty-six patients hospitalized for acute liver damage were divided into survival (n=35) and non-survival (n=11) groups. Univariate and multivariate analyses were used to identify significant factors that affected prognosis. Logistic regression analysis was performed to predict prognosis with effective factors. Ten independent factors with significant differences were identified and further analyzed for significance by logistic regression analysis. Among the 10 factors, age and LHL15/HH15 were identified as having meaningful differences for predicting convalescence. The following formula was developed: A negative value for R indicates non-survivals, and a positive value indicates survivals. The mortality rate was calculated as=1/(1+e(R)). The sensitivity was 0.909, specificity was 1.000, and accuracy was 0.978. The reliability of this formula was as good as that of another formula presented previously by the Intractable Liver Diseases Study Group of Japan. The use of (99m)Tc-GSA for estimating the prognosis of acute liver damage is useful, especially before the onset of hepatic encephalopathy.

Journal Article↗
PubMed2002

Modified scar grade: a prognostic indicator in small peripheral lung adenocarcinoma.

BACKGROUND: Several studies have shown the prognostic value of desmoplasia for lung adenocarcinomas. The authors evaluated the density and extent of desmoplasia by modifying the scar grade, as well as the prognostic impact on patient survival. METHODS: Modified scar grade was defined as follows: Grade 1, no desmoplasia; Grade 2, sparse desmoplastic reaction; Grade 3, dense desmoplastic reaction with diameter of 10 mm or less; Grade 4, dense desmoplastic reaction with diameter exceeding 10 mm. In addition, the prognostic impact of conventional histologic factors and modified scar grade was analyzed in 239 cases of small peripheral lung adenocarcinoma (maximum dimension, </= 30 mm) for which long-term follow-up data were available. RESULTS: The 5 and 10-year survival rates according to the modified scar grade were 100% and 100% for Grade 1 lung adenocarcinoma (n = 29); 91.7% and 83.7% for Grade 2 (n = 61); 67.6% and 52.7% for Grade 3 (n = 78); and 50.0% and 37.5% for Grade 4 (n = 71), respectively. A significant difference in patient survival was found between Grade 1 or 2 versus Grade 3 or 4 (P < 0.0001, by log rank test). Multivariate analysis showed that modified scar grade was an independent prognostic factor (P = 0.0176), as were pathologic stage (P = 0.0293), lymph node metastasis (P = 0.0191), lymphatic permeation (P = 0.0022), and pleural involvement (P = 0.0452). Modified scar grade also had a significant impact on survival in various subsets of patients, including those with pathologic Stage IA disease, patients with tumors of diameter 20 mm or less, or patients with mixed subtype tumors with a bronchioloalveolar component. CONCLUSIONS: Modified scar grade is a useful prognostic factor in patients with small lung adenocarcinomas. Tumors with a sparse fibroblastic reaction (modified scar Grade 2) may represent early invasive cancers or invasive cancers with low malignant potential, which should be distinguished from frankly invasive cancers (modified scar Grade 3 or 4).

Adenocarcinoma↗
PubMedDate not supplied

DNA ploidy and stromal bone formation as prognostic indicators of thyroid papillary carcinoma in aged patients: a retrospective study.

The prognostic value of flow cytometry for thyroid papillary carcinoma in aged patients was studied and compared with that of tumor histology. Seventy-five surgically removed primary papillary thyroid carcinomas larger than 30 mm in diameter were obtained from patients over 60 years of age. A subtotal thyroidectomy with modified radical neck dissection was performed in all patients. Sixteen female patients died of the carcinoma (non-survivors) and 18 survived longer than 12 years without recurrence (survivors). Histologically, papillary carcinoma was subclassified into poorly and well differentiated types, and the presence of stromal bone formation was noted. Flow cytometry was performed using paraffin-embedded materials. The incidence of the poorly differentiated type was 2/18 among the tumors of survivors and 6/16 among the tumors of non-survivors (P = 0.08). Stromal bone formation was only found in the tumors of the survivors (6/18 and 0/16; P = 0.014). In flow cytometry, tumors of the survivors showed a DNA diploid pattern (14/14), whereas half of the tumors of non-survivors (6/12) showed an aneuploid pattern (P = 0.004). Moreover, in the remaining six tumors of the non-survivors, two showed a third peak at 6C and one showed a higher S fraction. Therefore, only three showed a DNA diploid pattern that was indistinguishable from that of the survivors. These results suggest that flow cytometry is useful for estimating the prognosis of thyroid papillary carcinoma.

Aged↗
PubMed1995

Carcinoma of the prostate: race as a prognostic indicator in definitive radiation therapy.

PURPOSE: To characterize the racial differences in prognostic factors and treatment outcome for patients undergoing radiation therapy for carcinoma of the prostate. MATERIALS AND METHODS: From January 1975 through December 1989, 489 white and 157 black men with carcinoma of the prostate underwent irradiation. Factors analyzed were patient age, tumor stage and grade, prostate-specific antigen (PSA) levels, and disease-control and survival rates. RESULTS: More black patients than white patients were found to have poorly differentiated tumors. Black patients had higher PSA levels before and after treatment, resulting in a higher distant failure rate and poorer overall, cause-specific, and disease-free survival rates. CONCLUSION: Black men have more aggressive prostatic tumors, a higher rate of metastasis, and a poorer survival rate than do white men.

Aged↗
PubMed1993

Evaluation of prognostic indicators in squamous carcinoma of the vulva including nuclear DNA content.

The prognostic value of clinical and pathologic features including tumor ploidy status was evaluated in 43 randomly selected primary invasive squamous carcinomas of the vulva in which the lesion was totally excised and a lymph node dissection performed. By both univariate and multivariate analysis, survival most closely correlated with the number of involved lymph nodes. In the subgroup of patients with negative lymph node dissections, outcome was also found to correlate with tumor diameter but not with any other feature studied including nuclear DNA content. Both the FIGO surgical staging system and stratification of patients by Gynecologic Oncology Group (GOG) risk groups provided valuable methods of estimating prognosis with survival rates of 100%, 80%, 59%, and 25% for FIGO stages I, II, III, and IV, respectively, and rates of 100%, 75%, 56%, and 42% for GOG groups of minimal, low, intermediate, and high risk. Subdivision of patients with FIGO Stage III disease based on tumor diameter and the number of involved lymph nodes appeared to be of prognostic value with a survival rate of 67% when tumor diameter was below 8 cm and less than three lymph nodes were involved but only 50% when either value was above the cut-off point. This study suggests that DNA ploidy status is not a prognostic value in vulvar squamous carcinoma, but the results support the value of utilizing the number of involved lymph nodes for prognosis assessment. The latter feature in combination with tumor size may be useful in the subdivision of FIGO Stage III patients into prognostic subgroups.

Adult↗
PubMed1998

[Histopathological and molecular biological prognostic indicators of breast cancer].

Clinical stage and lymph node status are the strongest prognostic factors of patients with breast cancer. The estimation of the patient prognosis would be more accurate and more specific and effective therapy could be performed, if the indicators of biological properties of individual cancers are combined with these conventional factors. As indicators of such biological properties, we list a number of histopathological factors and molecular biomarkers, including specific gene and chromosome alterations. These factors provide knowledge not only about the biological aggressiveness of breast cancer cells but also concerning the pattern of preferential metastasis sites and sensitivity to specific therapies.

Breast Neoplasms↗
PubMedDate not supplied

Nuclear factor-kappaB p65 is a prognostic indicator in gastric carcinoma.

BACKGROUND: In common with other investigators, we have reported the constitutive activation of transcription factor nuclear factor-kappaB (NF-kappaB) in a variety of carcinomas, but there is no definite information on its clinical significance. MATERIALS AND METHODS: NF-kappaB p65 activation was determined by immunohistochemical analysis of surgically resected specimens from 63 gastric carcinomas. The 63 patients were divided into a high NF-kappaB group (21 patients) and a low NF-kappaB group (42 patients). Forty-seven of the 63 patients underwent curative resection. The 47 patients consisted of 13 high NF-kappaB patients and 34 low NF-kappaB patients. RESULTS: The high NF-kappaB group demonstrated a shorter overall survival rate compared with the low NF-kappaB group (p=0.015). In the 47 patients who underwent curative resection, the high NF-kappaB group also showed a poor survival prognosis (p=0.032). Multivariate analysis indicated that NF-kappaB activation is a potential prognostic factor in gastric carcinoma. CONCLUSION: Constitutive activation of NF-kappaB p65 may be a new prognostic parameter in gastric carcinoma.

Aged↗
PubMed2000

Prognostic indicators in venous ulcers.

BACKGROUND: Venous ulcers can be difficult to heal, and prognostic factors for healing have not been fully elucidated. OBJECTIVE: The objective of this study was to analyze the results of a large multicenter venous ulcer trial to retrospectively establish prognostic factors for venous ulcer healing. METHODS: This study examined data from a previously published prospective randomized placebo-controlled trial of an oral medication versus placebo treatment for venous ulcers. Local leg ulcer care involved the use of a moisture-retentive dressing and sustained graduated compression with a paste bandage and a self-adherent wrap. The oral medication or placebo was administered on a daily basis with the same dressings and bandage system in both groups for 12 weeks. A total of 165 patients completed the full 12-week treatment period; 83 received ifetroban, 82 received placebo. RESULTS: There was no statistically significant difference in outcome between the two groups. The study showed that consistent local ulcer treatment with a clearly defined system of care was associated with an unexpectedly high percentage (55%) of long-standing large venous ulcers (mean duration, 27 months; mean area, 15.9 cm(2)) being healed in both groups. Baseline ulcer area and duration of leg ulcer were found to be important in predicting outcome. Ulcers of short duration were found to be most likely to heal. Percent healing and ulcer area at week 3 were good predictors of 100% healing. Ulcers that had at least 40% healing by week 3 predicted more than 70% of the outcomes correctly. CONCLUSION: From this large study it was determined that baseline ulcer area and ulcer duration are significant predictors of 100% healing and time to heal. Percent healing and ulcer area at week 3 are good predictors of complete ulcer healing. Ulcers that are large, long-standing, and slow to heal after 3 weeks of optimal therapy are unlikely to heal rapidly, and might benefit from alternative therapies.

Double-Blind Method↗
PubMed2003

Maximum gastric cancer diameter as a prognostic indicator: univariate and multivariate analysis.

It was suggested that there are no stronger prognostic factors in gastric cancer than nodal involvement or depth of wall invasion. The present paper evaluated the influence of maximum tumor diameter (MTD) value, measured on fixed resected specimens, on the extent of disease progression and the outcome in gastric cancer patients. Clinicopathological data were retrospectively retrieved from records of 122 patients who underwent curative gastrectomy. The patients' MTD values were grouped as follows: MTD1, up to 26 mm; MTD2, between 26 and 50 mm; and MTD3, over 50 mm. The three groups evidenced significant differences with regard to 5 year survival (MTD1: 54%, MTD2: 31%, MTD3: 20%; p = 0.00027), furthermore they were significantly different with respect to the type of gastrectomy (p = 0.021), depth wall invasion (p = 0.000), lymphatic microinvasion (p = 0.014), perineural microinvasion (p = 0.017), stromal reaction (p = 0.025), and stage (p = 0.035). ROC curve analysis individuated a best accurate MTD threshold value for nodal involvement of 32 mm (sensitivity = 56.6%; specificity = 60.9%; positive predictive value = 52.6%; negative predictive value = 64.6%). The logistic regression analysis suggested that the depth of wall invasion was the only independent variable associated with MTD value (p = 0.0005). Multivariate analysis showed that independent prognostic risk factors were sex (p < 0.0025), number of involved nodes (p < 0.001) and MTD (p < 0.001). In conclusion, the maximum tumor diameter value of gastric cancer may be a factor with greater prognostic implications than previously believed.

Aged↗
PubMed1981

The value of prognostic indices in aplastic anaemia.

In 43 patients with aplastic anaemia we assessed the accuracy of different prognostic systems. Patients dying within 6 months after diagnosis were correctly predicted in 60% of cases with the Lynch-index with a sensitivity of 82%. With the Najean-index 40% of these patients are correctly predicted, this index has a sensitivity of 100%. More accurate are the prognostic criteria proposed by Camitta et al [5]. With these criteria, this rapidly fatal group is correctly predicted in 85% of the patients, indicating that 15% of the patients are incorrectly predicted to have a limited survival. The sensitivity, however, is 100%. The Lohrmann-index, based on reticulocyte count predicts 64% of this group with severe aplasia. None of these prognostic systems do accurately predict long survival. We suggest that the best differentiation between patients with a long-term prognosis (more than 5 years) and patients who die from aplastic anaemia within 5 years, is made by re-evaluating the leucocyte and platelet count 3 months after the initial diagnosis. Decrease in blood counts (over 10%) predicts death from aplastic anaemia within 5 years correctly in all patients; stable or increased blood counts predict long survival in 75% of the patients.

Anemia, Aplastic↗
PubMed1995

[Proliferating cell nuclear antigen expression as a prognostic indicator for renal cell carcinoma: comparison with pathologic features and DNA content].

In the present study the prognostic value of proliferating cell nuclear antigen (PCNA) index and tumor DNA content were evaluated in 100 patients with renal cell carcinoma. The survival rate of patients with aneuploid tumors was not significantly different from that of those with diploid tumors. DNA ploidy could not be a prognostic factor. PCNA expression was determined by immunohistochemical staining using the PC10 clone. PCNA indices ranged from 2.6 to 33.6% with mean indices of 10.2, 15.7 and 27.9% for grades 1 to 3. There was a significant difference between the indices of each grade of tumor. Patients with a PCNA index of less than 13.6% had a longer survival time than the patients having tumors with a PCNA index of more than 13.6% (p < 0.05). Furthermore, within the group of grade 2 tumors, patients with a lower PCNA index had a significantly better prognosis (p < 0.05). Our findings demonstrated that the PCNA index provides significant prognostic information for renal cell carcinoma.

Adolescent↗
PubMedDate not supplied

Angiogenesis as a prognostic indicator in pancreatic ductal adenocarcinoma.

BACKGROUND: Angiogenesis has gained wide acceptance as a reliable prognostic factor in several solid tumors. However, to date, experience in pancreatic adenocarcinoma is limited. MATERIALS AND METHODS: Specimens from 45 patients radically operated on at our departments from 1988 to 1997 were stained immunohistochemically with the antibodies anti-mutant p53, anti-bcl2, anti Ki67 and anti-CD31. All the slides were reviewed by the same pathologist without knowledge of the patients' outcome. RESULTS: Mutant p53, Ki67 index and vessel count were significantly related to tumoral behaviour and patients' outcome. Among patients with nodal involvement (Stage III), cumulative survival between hypovascular and hypervascular subgroups differed significantly (p = 0.03). Angiogenesis was independent from TNM in assessing the patients'prognosis at COX analysis (p = 0.02). CONCLUSION: In patients with pancreatic adenocarcinoma, angiogenesis is a reliable indicator of tumor extension, lymph node status and survival. Its evaluation as a common procedure may contribute to a further improvement in the management of these patients and to a proper selection of those who could benefit from different follow-up protocols or adjuvant treatment.

Carcinoma, Pancreatic Ductal↗