Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Prognostic indicators”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMedDate not supplied

Clinical characteristics and prognostic indicators of drug-induced fulminant hepatic failure.

BACKGROUND/AIMS: In most cases of drug-induced liver injury, it is difficult to diagnose whether these cases would progress to fulminant hepatic failure. We investigated the characteristics of non-viral and suspiciously drug-induced fulminant hepatic failure by comparing clinical data between cases that progressed and those that did not progress to fulminant hepatic failure. METHODOLOGY: Ninety-five cases of suspicious drug-induced liver injury including 22 cases that had been treated at our hospital, and subsequently progressed to fulminant hepatic failure were involved in this study. We investigated the characteristics of drug-induced fulminant hepatic failure by a comparison of non-fulminant and fulminant cases, and simultaneously of survivors and fatal cases in the group of fulminant cases. RESULTS: Many of the clinical variables were significantly deteriorated in fulminant cases. The latent period, which means the duration of drug administration, correlated with the severity of drug-induced liver injury including fulminant hepatic failure. Suspicious cases of drug-induced liver injury where the bilirubin level at the time of definite diagnosis stayed over 13 mg/dL for more than one month were likely to progress to fulminant hepatic failure. CONCLUSIONS: Our results suggest that the latent period and the peak level of total bilirubin would be prognostic factors for the severity of drug-induced fulminant hepatic failure. Early preparation of liver transplantation should be recommended by referring these characteristics.

Adult↗
PubMed2004

Intraoperative pleural lavage cytology is an independent prognostic indicator for staging non-small cell lung cancer.

OBJECTIVES: For patients undergoing lung resection for cancer, macroscopic evidence of metastasis is clearly associated with adverse prognosis. However, less is known about the significance of tumor cells detected by using tests such as pleural lavage cytology. To ascertain the frequency and quantify the effect of this finding on survival, we performed a prospective study of intraoperative pleural lavage cytology. METHODS: Pleural lavage cytology consisted of cytologic analysis of 100 mL of saline irrigated over the lung surface immediately after thoracotomy. Patients were excluded if they had an existing effusion, extreme adhesions, or lateral chest wall invasion or if resection was not performed. Survival was calculated by means of Kaplan-Meier analysis and compared by using log-rank tests. Cox regression was used to ascertain independent predictors of prognosis. RESULTS: From 1995 through 2003, we performed pleural lavage cytology on 292 patients undergoing thoracotomy for lung cancer. The mean age was 64 (SD, 10) years, and 196 (67%) patients were men. Of 292 samples, 13 (4.5%) showed evidence of malignant cells. The median time to follow-up was 15 months (interquartile range, 1-40 months), with a median survival of 49 months for patients with negative pleural lavage cytology results and 13 months for patients with positive pleural lavage cytology results (P =.002). Univariate prognostic predictors were positive pleural lavage cytology status (P =.03), stage (P =.03), adenocarcinoma (P =.06), and parietal pleural involvement (P =.01). In the final multivariate model only positive pleural lavage cytology status (P =.006) and stage (P =.03) remained significant. CONCLUSIONS: Intraoperative pleural lavage cytology is a simple addition to intrathoracic staging and an independent predictor of prognosis. Positive results potentially affect survival by upstaging patients to stage IIIB or greater.

Adenocarcinoma↗
PubMedDate not supplied

p53 oncoprotein as a prognostic indicator in patients with breast cancer.

UNLABELLED: p53 is a tumor suppressor gene located on the human chromosome 17 that is thought to regulate (suppress) the proliferation of normal cells. The mutant protein accumulates in the nuclei of tumor cells that may then have a proliferative advantage over normal cells. The purpose of this study was to investigate the relationship between levels of mutant p53 expression and the clinical outcome of patients with node-positive and node-negative breast cancer. Expression of mutant p53 was evaluated in 655 human breast carcinomas (349 node-positive and 306 node-negative patients) with long-term clinical follow-up by immunohistochemistry in sections from paraffin embedded tumors. RESULTS: Immunoreactivity was found in 37.3% of breast tumors. There was no significant correlation between the expression of p53 and tumor size, nodal involvement, age or histological type. However, p53 overexpression was clearly related to histological grade and steroid receptors, with a trend to higher overexpression in ER-tumors or in those with a high histological grade (p < 0.01). On univariate analysis positive tumors were associated with reduced DFS in the total group (p < 0.001) as well as in node-positive patients (p < 0.05) and in node-negative patients (p < 0.01). In conclusion, these results suggest that the immunoreactivity of p53 may be a biologic marker of prognostic significance in both node-positive and node-negative patients.

Biomarkers, Tumor↗
PubMed2005

Mutations in the epidermal growth factor receptor and in KRAS are predictive and prognostic indicators in patients with non-small-cell lung cancer treated with chemotherapy alone and in combination with erlotinib.

PURPOSE: Epidermal growth factor receptor (EGFR) mutations have been associated with tumor response to treatment with single-agent EGFR inhibitors in patients with relapsed non-small-cell lung cancer (NSCLC). The implications of EGFR mutations in patients treated with EGFR inhibitors plus first-line chemotherapy are unknown. KRAS is frequently activated in NSCLC. The relationship of KRAS mutations to outcome after EGFR inhibitor treatment has not been described. PATIENTS AND METHODS: Previously untreated patients with advanced NSCLC in the phase III TRIBUTE study who were randomly assigned to carboplatin and paclitaxel with erlotinib or placebo were assessed for survival, response, and time to progression (TTP). EGFR exons 18 through 21 and KRAS exon 2 were sequenced in tumors from 274 patients. Outcomes were correlated with EGFR and KRAS mutations in retrospective subset analyses. RESULTS: EGFR mutations were detected in 13% of tumors and were associated with longer survival, irrespective of treatment (P < .001). Among erlotinib-treated patients, EGFR mutations were associated with improved response rate (P < .05) and there was a trend toward an erlotinib benefit on TTP (P = .092), but not improved survival (P = .96). KRAS mutations (21% of tumors) were associated with significantly decreased TTP and survival in erlotinib plus chemotherapy-treated patients. CONCLUSION: EGFR mutations may be a positive prognostic factor for survival in advanced NSCLC patients treated with chemotherapy with or without erlotinib, and may predict greater likelihood of response. Patients with KRAS-mutant NSCLC showed poorer clinical outcomes when treated with erlotinib and chemotherapy. Further studies are needed to confirm the findings of this retrospective subset analysis.

Adult↗
PubMed2001

Loss of chromosome 11q21-23.1 and 17p and gain of chromosome 6p are independent prognostic indicators in B-cell non-Hodgkin's lymphoma.

Comparative genomic hybridization (CGH) was employed to study chromosomal aberrations in relation to cell proliferation, apoptosis, and patient survival in 94 cases of B-cell non-Hodgkin's lymphoma diagnosed between 1983 and 1993. Eighty cases had aberrations by CGH. Chromosomal regions 1p21-31.1 (10%), 6cen-q24 (12%), 8p (11%), 9p21-ter (14%), 11q21-23.1 (11%), 13q13-21.1 (12%), and 17p (15%) were frequently lost. Gains were found at 3q21-ter (22%), 6p (11%), 7p (12%), 8q23-ter (13%), 12cen-q15 (17%), 17q24-ter (13%), and 18q13.3-21 (20%). A high number of aberrations (> or = 4, 33 cases) was associated (P < or = 0.001) with the mantle cell and diffuse large B-cell lymphoma subtypes, a high fraction of tumour cells in S phase, and short survival (RR (relative risk) = 3.7). Loss of 1p21-31.1, 8p, 9p21-ter, 11q21-23.1, and 13q13-21.1 were associated with mantle cell lymphoma (P < or = 0.03), while gain of 6p and 12cen-q15 were more frequent in diffuse large B-cell and small lymphocytic lymphoma, respectively (P = 0.04). Loss of 8p and 17p, and gain of 3q21-ter, 6p, 7p, and 8q23-ter were associated with a high S phase fraction (P < or = 0.03), but none of the aberrations were associated with tumour apoptotic fraction (P > or = 0.13). The most important prognostic CGH parameters (P < 0.001) were losses of 11q21-23.1 (RR = 3.8) and 17p (RR = 4.4), and gain of 6p (RR = 4.2). The latter parameters and IPI were the only ones with independent prognostic value (RR = 10, 5.0, 6.7, and 3.7, respectively; P < 0.001) when assessed together with lymphoma sub-type, primary versus relapse cases, treatment, B symptoms, S phase fraction, and presence of BCL1 and BCL2 translocations. A combined CGH/IPI binary parameter had high prognostic value for patients receiving different treatments, with various lymphoma sub-types, and for primary as well as relapse cases.

Adult↗
PubMed1992

Peritumoral lymphatic vessel invasion compared with DNA ploidy, proliferative activity, and other pathologic features as prognostic indicators in operable breast cancer.

In 164 breast carcinomas the presence of peritumoral lymphatic vessel invasion (PLVI) was evaluated and correlated with other known indicators of prognosis and with the clinical outcome of the patients. Overall 22% of tumors were PLVI-positive. The presence of PLVI was significantly associated with axillary node involvement (p less than 0.0001) and tumor size (p = 0.005), and tended toward an association with grading (p = 0.065). No significant association was found between PLVI and steroid hormone receptors, DNA ploidy, or proliferative activity. Univariate analysis shows that peritumoral vessel invasion was significantly associated with a higher risk of recurrence (p = 0.012) and with a trend toward shorter survival (p = 0.074). Besides the presence of PLVI, prognosis was significantly worse also for patients with high proliferative aneuploid tumors and with axillary node metastases. Moreover, within the subsets of patients generally considered to have good prognosis, the presence of PLVI identified patients with a trend for higher risk such as those with PLVI-positive diploid tumors, PLVI-positive low-proliferative tumors, and PLVI-positive node-negative tumors. Adopting multivariate analysis, PLVI failed to retain prognostic importance when adjusted for node status, DNA ploidy, and proliferative activity. In conclusion, we found that the presence of PLVI has prognostic significance when singly evaluated. Multivariate analysis shows that PLVI is not an independent prognostic factor in stage I-II breast cancer.

Adult↗
PubMed1992

Microangiopathy as a prognostic indicator in diabetic patients suffering from acute myocardial infarction.

Diabetic patients have an increased mortality following myocardial infarction (MI) due to left ventricular failure rather than larger infarcts or dysrhythmias. As this may be due to diabetic microangiopathy affecting the myocardium, we have examined the case records of diabetic clinic patients admitted to the Coronary Care Unit (CCU) with proven MI and compared the hospital outcome of those with and without retinopathy or nephropathy, i.e. markers for generalised microangiopathy. Sixty four consecutive records were traced, for the period when diabetic treatment policy was standardised in CCU, 24 patients had retinopathy (7 proteinuria). When compared to non-retinopathy patients they had similar ages 67 +/- 12 yr [+/- SD] v 63 +/- 9yr) but were of longer duration of diabetes p less than 0.05). There were no differences between the groups in size or site of infarct, previous infarct or hypertension history, blood glucose on admission or diabetic treatment before or after admission. Death occurred in 29% of retinopathy patients compared to 3% of non-retinopathy patients (p less than 0.01). Cardiac failure complicated 75% of retinopathy patients and 25% of non-retinopathy patients (p less than 0.001). Dysrhythmia occurred in 50% and 33% of patients respectively (P = NS). Nine patients had clinical peripheral vascular disease and five of these died. This study, of a selected group of diabetic clinic attenders admitted to CCU with acute MI, demonstrates that microangiopathy and peripheral vascular disease are important prognostic factors in determining hospital outcome as these patients are at increased risk of cardiac failure and death.

Aged↗
PubMed1994

[The prognostic indicators of a favorable clinical evolution in dilated cardiomyopathy].

Improvement in cardiac function and clinical status has been described in subgroups of patients with dilated cardiomyopathy (DCM), but predictors of favourable outcome have not been unequivocally established. In 33 patients with DCM followed up for a mean of 23 months (range 3-68) a full non-invasive and invasive diagnostic work-up, including endomyocardial biopsy, was performed. At the end of the follow-up, 13 patients (39%; Group A) showed a significant improvement in their clinical status (> or = 1 gain in NYHA functional class) and cardiac function (> 0.10 increase in echocardiographic ejection fraction), while 20 (61%; Group B) either stabilized or deteriorated (5 died and 4 underwent successful heart transplantation). Clinical, hemodynamic and morphometric data of the 2 groups were compared. Only lower systemic vascular resistance (Group A 2,836 +/- 637 versus Group B 3,637 +/- 1113; p = 0.025) and higher prevalence of alcohol intake > 80 g/day (Group A 85% versus Group B 40%; p = 0.03) were significantly associated with improvement. Discriminant analysis utilizing these 2 variables along with cardiac index, mitral regurgitation, pulmonary resistance and cardiothoracic ratio reached a discriminant power of 72% (p = 0.0014). The above results suggest that, in our series, relatively simple data provide the most accurate assessment of prognosis. Yet, prediction of favourable versus unfavourable outcome remains uncertain, since an incorrect prognosis will be made in 28% of cases. Morphometric analysis of endomyocardial bioptic specimens does not provide significant prognostic information. The identification of a high alcohol intake has a clinical relevance, since abstention from alcoholic beverages is significantly associated with a favourable outcome in our patients.

Adult↗
PubMed2005

Evaluation of handgrip strength as a nutritional marker and prognostic indicator in peritoneal dialysis patients.

BACKGROUND: Serum albumin has limitations as a nutritional marker in patients undergoing peritoneal dialysis (PD) in that it is affected by inflammation, systemic disease, overhydration, and urinary and dialysate protein loss. Handgrip strength is a simple, easily performed bedside test that has been shown to correlate with lean body mass in patients close to inception of dialysis. OBJECTIVE: We evaluated the associations of handgrip strength with other clinical factors and examined its relations with mortality and cardiovascular death in PD patients. DESIGN: We prospectively enrolled 233 chronic PD patients and assessed handgrip strength and other variables at baseline and then followed the patients for a mean (+/-SD) of 30 +/- 14 mo. RESULTS: Baseline handgrip strength was significantly associated with age, sex, height, diabetes, residual glomerular filtration rate (GFR), and hemoglobin but not with C-reactive protein (CRP). After adjustment for age, sex, and height, handgrip strength was most strongly correlated with lean body mass on the basis of creatinine kinetics (r = 0.334, P < 0.001), followed by serum albumin and subjective global assessment. Both men and women who died had lower handgrip strengths than did those who remained alive (P < 0.001). After control for age, sex, diabetes, atherosclerotic vascular disease, GFR, hemoglobin, CRP, and serum albumin, greater handgrip strength was predictive of lower all-cause [hazards ratio (HR): 0.95 (95% CI: 0.92, 0.99); P = 0.005] and cardiovascular [HR: 0.94 (0.90, 0.98); P = 0.004] mortality. CONCLUSIONS: Handgrip strength not only is a marker of body lean muscle mass but also provides important prognostic information independent of other covariates, including CRP and serum albumin. Our data suggest that handgrip strength may be used in conjunction with serum albumin as a nutrition-monitoring tool in patients undergoing PD.

Cardiovascular Diseases↗
PubMed2005

Lymphovascular and marginal invasion as useful prognostic indicators and the role of c-erbB-2 in patients with male extramammary Paget's disease: a study of 31 patients.

PURPOSE: Extramammary Paget's disease (EMPD) is a rare intraepithelial neoplasm arising in skin that bears apocrine glands. We analyzed clinical, pathological and immunohistochemical staining patterns in 31 cases of EMPD to assess possible predictors of outcome, including patient age, sex, involved organs, surgical margin status, invasion depth, lymphovascular invasion, adnexal invasion, and immunoreactivity for cytokeratin 7 and 20, carcinoembryonic androgen, androgen receptor, p53, c-erbB-2 (Dako, Carpinteria, California) and Ki67. MATERIALS AND METHODS: A total of 31 cases of EMPD were retrieved from the surgical pathology files of the department of pathology along with the medical records of the department of urology. Dermal invasion depth, tumor margin status, adnexal invasion and lymphovascular invasion were determined from the hematoxylin and eosin stained slides of each case. RESULTS: Eight of the 31 cases (25.8%) experienced local recurrence. Two of 3 patients with and 6 of 28 without lymphovascular invasion experienced recurrence (p = 0.029). Dermal invasion significantly correlated with Her-2 over expression (Wilcoxon 2-sample test p = 0.0007). When the criteria of 1 and 5 mm invasion were applied, each validly correlated with Her-2 over expression. Her-2 over expression (grades 2 and 3) significantly correlated with p53 over expression (Wilcoxon rank test p = 0.0015). C-erbB-2 was positive in 51.6% of EMPD cases, in which it was strongly associated with dermal invasion and p53 over expression. CONCLUSIONS: The most valid prognostic factor in male EMPD for predicting late recurrence is lymphovascular permeation and marginal status.

Aged↗
PubMed2001

End-tidal carbon dioxide measurements as a prognostic indicator of outcome in cardiac arrest.

PURPOSE: To evaluate the use of end-tidal carbon dioxide values in predicting survival in cardiopulmonary arrest. BACKGROUND: The decision about when to terminate resuscitative efforts for patients with cardiopulmonary arrest is often subjective. End-tidal carbon dioxide values have been suggested as potential objective criteriafor making this decision. METHODS: This study was a cooperative effort of the St Louis chapter of the American Association of Critical-Care Nurses and its members and involved 6 hospitals and an air evacuation service. All adult patients who had a cardiopulmonary arrest were eligiblefor the study. Once a patient with cardiac arrest was intubated, end-tidal carbon dioxide and cardiac rhythms were measured and recorded every 5 minutes for 20 minutes or until resuscitation efforts were terminated. Patients' survival at the time of the arrest, survival 24 hours after the arrest, and discharge status were followed up. RESULTS: A total of 127 patients were enrolled in the study. All but 1 patient with end-tidal carbon dioxide values less than 10 mm Hg died before discharge. End-tidal carbon dioxide values greater than 10 mm Hg were associated with various degrees of survival. Overall survival to discharge was less than 14%, regardless of the end-tidal carbon dioxide value. CONCLUSION: Measurements of end-tidal carbon dioxide can be used to accurately predict nonsurvival of patients with cardiopulmonary arrest. End-tidal carbon dioxide levels should be monitored during cardiopulmonary arrest and should be considered a useful prognostic value for determining the outcome of resuscitative efforts.

Capnography↗
PubMed2002

Extent of mesorectal invasion is a prognostic indicator in T3 rectal carcinoma.

BACKGROUND: The aim of this study was to determine if local recurrence (LR) rates in patients with minimally invasive and advanced T3 rectal cancer are different. This may influence the use of adjuvant therapy. METHODS: Consecutive patients with T3 rectal cancer undergoing curative surgery were classified into minimally invasive or advanced groups. Minimally invasive T3 was defined as a tumour that had invaded beyond the muscularis propria on microscopic examination only, whereas advanced T3 tumours had invasion beyond the muscularis propria that was obvious on macroscopic examination and confirmed histologically. Local recurrence rates of the two groups were compared by construction of Kaplan-Meier curves. The log-rank test was used to determine equivalence, and Cox regression to estimate the hazard ratio. The Grambsch- Therneau test and graphical comparison of predicted and observed Kaplan-Meier curves was used to test the proportional hazards assumption. RESULTS: There were 222 patients in total, 74 in the minimally invasive group and 148 in the advanced. The overall LR rate was 11.2%. The LR rates in the minimally invasive and advanced groups were 5.4% and 14.2%, respectively. The log-rank test gives a P value of 0.042 for equivalence, with the minimally invasive patients doing significantly better. The hazard ratio estimated by Cox regression was 0.35 (early relative to advanced), 95% confidence intervals (0.12, 1.0). There was no evidence of confounding by age at surgery, pathology type, gender or postoperative adjuvant therapy. CONCLUSIONS: The extent of invasion into the mesorectum appears to be an independent prognostic variable. If oncologically sound surgical techniques are employed, the LR rate of patients with minimal invasion is low. Adjuvant therapy may not confer additional benefit in this group.

Adenocarcinoma↗
PubMed2006

Focal adhesion proteins as markers of malignant transformation and prognostic indicators in breast carcinoma.

Focal adhesion kinase (FAK) is one of the central signaling molecules found at focal adhesion sites, which are specific areas on the cell membrane where cells attach to extracellular matrix proteins. Focal adhesion kinase interacts with multiple signaling and adaptor molecules and effects several signaling pathways. Overexpression of FAK and its substrate c-Src has been implicated in malignant transformation and acquisition of an invasive tumor phenotype of different tissues. Overexpression of the multidomain protein paxillin, which is also a FAK ligand and a c-Src substrate, has been associated with less malignant tumor behavior. The purpose of this study was to analyze the involvement of integrin signaling molecules FAK, c-Src, and paxillin in malignant transformation of the breast epithelium. Using phosphospecific antibodies FAK-pY(397) and Src-pY(416), we demonstrated that neither activation of FAK nor activation of c-Src correlates with development of invasive tumor properties. However, activation of both FAK and c-Src correlates with malignant transformation. We further demonstrated that overexpression of paxillin also correlates with malignant transformation and is a marker of a less invasive tumor phenotype. Using tissue microarray, we demonstrated that expression and activation of paxillin inversely correlated with lymph node metastases and lymphovascular invasion, respectively. No correlation between paxillin expression and activation and tumor grade, estrogen, progesterone, and Her2/Neu receptor expression was found. In summary, focal adhesion proteins FAK and c-Src can be used as markers of malignant transformation in epithelial cells but not invasive phenotype, whereas expression and activation of paxillin may represent a good prognosticator in breast carcinoma.

Biomarkers, Tumor↗
PubMed2004

Hepsin is highly over expressed in and a new candidate for a prognostic indicator in prostate cancer.

PURPOSE: Other cDNA microarray studies have shown that hepsin is one of the highly over expressed genes in prostate cancer tissue compared with nonmalignant and benign prostatic hyperplasia tissue. We quantitatively analyzed hepsin gene expression with real-time polymerase chain reaction and calculated its relationships with clinicopathological parameters in a large cohort of samples. MATERIALS AND METHODS: Matched prostate tissue samples from the cancerous and noncancerous parts of the same prostates were obtained from 90 patients with prostate cancer who underwent radical prostatectomy. Quantitative reverse transcriptase-polymerase chain reaction was performed using LightCycler Fast Start DNA Master SYBR Green I on a LightCycler (Roche Diagnostics GmbH, Mannheim, Germany) system. The ratio of hepsin-to-beta-actin (a housekeeping gene) was used to normalize data. RESULTS: Hepsin over expression in cancerous compared with noncancerous tissue was found in 81 of the 90 patient samples (90%, p <0.001). In 48 patients (53%) hepsin over expression was more than 10-fold in cancerous tissue. The ratio of cancerous-to-noncancerous hepsin expression was significantly higher in the 39 patients with grade 3 tumors compared with the 51 with grade 2 tumors (median 15.5 vs 9.6, p = 0.031). For the prognosis a cutoff at the 75th percentile provided a significant difference between patients at lower risk (pT2, G2 and Gleason score less than 7) and higher risk (pT3/4, G3 and Gleason score 7 or greater) for relapse. CONCLUSIONS: This report of the quantitative analysis of hepsin expression, which is the first to our knowledge, shows strong and significant over expression in prostate cancer tissue. Hepsin expression may be a new prognostic marker that could be used for assessing prostate cancer aggressiveness.

Adenocarcinoma↗
PubMed2004

Galectin-3 - an emerging prognostic indicator in advanced head and neck carcinoma.

Galectin-3, is a multifunctional effector. It is the only chimera-type member of the galectin family of endogenous lectins, which share specificity with beta-galactosides and have a jelly-roll-like folding pattern. It's activity profile includes modulation of cell-cell and cell-extracellular matrix interactions and the regulation of proliferation and apoptosis/anoikis. While lectin histochemistry with plant/invertebrate proteins is routine practice and immunohistochemical analysis of endogenous lectins has been thoroughly examined, the application of an endogenous lectin as a marker is presently primarily a promising concept. The aims of our study were to test galectin-3 as a technical probe and to correlate staining by the tissue lectin, localising accessible ligands in situ, to clinicopathological characteristics and the prognosis of patients (relapse-free and overall survival) in advanced head and neck squamous cell cancer. We measured galectin-3-dependent staining in 53 surgically resected oropharyngeal and laryngeal cancer specimens (stage III or IV). Patients were divided into two groups based on a threshold of 5% positivity in the tumour cell population. The patient's degree of positivity was significantly correlated with their level of differentiation and keratinisation and lack of lymph node involvement (P=0.0001, P=0.0007 and P=0.0224, respectively). Periods of relapse-free and overall survival were significantly shortened when the tumour population failed to meet the positivity criterion, i.e. to harbour ligands for the endogenous lectin (P=0.0039 and P=0.0259, respectively). We conclude that (a) studies with an endogenous lectin as a marker are technically feasible and (b) detection of accessible galectin-3-specific ligands is an independent prognostic marker in advanced head and neck squamous cell cancer with therapeutic potential. Of note, histochemical application of an endogenous effector after its purification and labelling may bear relevance beyond the galectins.

Aged↗
PubMed2007

Temporomandibular joint internal derangement and osteoarthrosis: are effusion and bone marrow edema prognostic indicators for arthrocentesis and hydraulic distention?

PURPOSE: Arthrocentesis and hydraulic distention of the temporomandibular joint (TMJ) has proven to be an effective modality in treating patients exhibiting clinical findings consistent with the diagnosis of disc displacement without reduction. The purpose of this study was to investigate whether the magnetic resonance imaging (MRI) variables of effusion and/or bone marrow edema may predict treatment outcomes of arthrocentesis and hydraulic distention of the TMJ. PATIENTS AND METHODS: The study group comprised 37 consecutive patients with TMJ pain, who were assigned a unilateral clinical TMJ disorder of TMJ pain associated with an internal derangement (ID) type III (disc displacement without reduction) and a TMJ pain side-related MRI diagnosis of disc displacement without reduction associated with osteoarthrosis (OA). Bilateral sagittal and coronal MRI images were obtained immediately before the operation to establish the presence or absence of ID, OA, TMJ effusion, and bone marrow edema. Pain level and mandibular range of motion (ROM) were assessed preoperatively and compared with the respective 2-month follow-up findings. Outcome criteria for success were a ROM >or=35 mm and pain reduction >50%. A logistic regression analysis was used to compute the odds ratio for TMJ effusion and bone marrow edema for successful outcomes (n = 21) versus unsuccessful (n = 16) outcomes. RESULTS: At the 2-month follow-up, clinical evaluation showed a significant reduction in TMJ pain during function (P = .000), a significant reduction in clinical diagnoses of TMJ disorders (P = .016), and a significant increase in ROM (P = .000). A significant increase in the risk of an unsuccessful outcome of ROM <35 mm and/or pain reduction >or=50% occurred with MRI findings of effusion (odds ratio 1:10.8 = 0.09; P = .007). CONCLUSIONS: TMJ effusion may prove to be an important prognostic determinant of successful arthrocentesis. However, the data re-emphasize the concept that the prediction of a specific outcome is not a matter of simple linearity, in which the presence of 1 factor may equate with predictive ability, but rather is a function of a complex interaction among different biological variables.

Adolescent↗
PubMed2001

Oesophageal basaloid squamous cell carcinoma: a unique clinicopathological entity with telomerase activity as a prognostic indicator.

Oesophageal basaloid squamous cell carcinoma (BSCC) is uncommon and has been reported to have a worse prognosis than squamous cell carcinomas (SCCs), but this tumour has not been fully characterized. The aim of the present study was to analyse the clinicopathological features of a large cohort of patients with oesophageal BSCC treated at a single institution. The pathology of 756 primary oesophageal cancers treated between January 1989 and December 1998 was reviewed. Tumours that fulfilled the diagnostic criteria of BSCC were identified and were compared with SCC. Their expression of MIB-1, DNA ploidy, and telomerase activity were also studied. Thirty Chinese patients (25 men and five women) with BSCC were found, comprising 4% of patients with oesophageal cancer treated by surgical resection in the study period. Their median age was 67 years (range 40-78 years). Dysphagia was usually the main presenting symptom. Other concomitant malignant tumours were seen in three patients and paraneoplastic glomerulopathy in one. Five tumours were located in the upper third, 19 in the middle third, and six in the lower third. The median length was 5.8 cm (range 2-12 cm). The median MIB-1 score of BSCC was 750 (range 400-858) and was higher than that of SCC (p=0.003). The primary tumour and metastatic BSCC were aneuploid, as detected by flow cytometric analysis in nine patients. Telomerase activity was positive in 95% (19 out of 20) of the cases analysed. The 5-year survival of patients with BSCC was 12%. Distant metastases were seen in 53% (n=16); lung and liver were the most common sites. The median survival of patients with tumours which had a high level of telomerase activity was significantly shorter than those with low levels of telomerase activity (1 vs. 27 months) (p=0.001). The median survival of patients with BSCC and SCC was 26 and 16 months, respectively (p=0.3). In conclusion, BSCC has distinctive clinicopathological features and its long-term prognosis is no worse than SCC. The level of telomerase activity may have a prognostic role.

Adult↗
PubMed2003

Prognostic indicators of the outcome of arthrocentesis: a short-term follow-up study.

OBJECTIVES: Arthrocentesis of the temporomandibular joint (TMJ) is purported to be an effective modality in the treatment of patients with closed-lock symptoms. The purpose of this study was to determine whether the clinical findings of disk displacement without reduction associated with pain in the TMJ are related to the discovery of TMJ osteoarthrosis (OA) through the use of magnetic resonance (MR) imaging and whether the presence of OA affects the treatment outcome of patients who undergo arthrocentesis of the TMJ. STUDY DESIGN: The study population consisted of 38 patients with TMJ pain who were assigned a clinical diagnosis of unilateral internal derangement (ID) of the TMJ, type III (disk displacement without reduction), in combination with capsulitis/synovitis (C/S) and an MR imaging diagnosis of disk displacement without reduction in the painful TMJ only. Before the patients underwent arthrocentesis, bilateral sagittal and coronal MR images were obtained to confirm the presence or absence of ID and OA. The preoperative and postoperative levels of TMJ function with respect to pain and mandibular range of motion were evaluated and compared. Multiple logistic regression analysis was used to compute the odds ratios for successful outcomes for OA (n = 24) versus unsuccessful outcomes for TMJs (n = 14). RESULTS: The preoperative data revealed a significant relationship between the clinical diagnosis of TMJ ID type III with C/S and the discovery of OA on MR images (P =.048). At the 2-month follow-up, a clinical evaluation revealed a significant reduction in TMJ pain during function (P =.000); a significant reduction in the clinical diagnoses of ID type III (P =.000), and C/S (P =.000); and a significant increase in the mandibular range of motion (P =.000). The patients with successful outcomes were more likely to be associated with an MR imaging finding of OA than were the patients with unsuccessful outcomes. (10.4 odds ratio; P =.016). CONCLUSIONS: Our preliminary findings suggest that the presence of OA revealed on MR images is related to clinical pain; furthermore, OA proved to be an important prognostic determinant of successful arthrocentesis.

Adolescent↗