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PubMed2025

Expression and prognosis of CXCL13 in uterine corpus endometrial carcinoma based on bioinformatics analysis.

OBJECTIVE: The biological significance of the chemokine ligand C-X-C motif chemokine ligand 13 (CXCL13) may play a significant role in the pathogenesis of uterine corpus endometrial carcinoma (UCEC). This study aims to identify and verify CXCL13 with predictive value for prognosis in UCEC. METHODS: CXCL13 mRNA expression differences were analyzed using R software in three independent datasets: one each from The Cancer Genome Atlas (TCGA) and two from the Gene Expression Omnibus (GEO), namely GSE17025 and GSE106191. The correlation between CXCL13 expression and prognosis was evaluated by Kaplan-Meier analysis. Univariate and multivariate Cox analyses were utilized to construct a prognostic nomogram. Tumor Immune Estimation Resource (TIMER) and the Tumor and Immune System Interaction Database (TISIDB) were employed to assess the relationship between CXCL13 and tumor immune infiltration. Coexpressed genes with CXCL13 were identified by the Spearman correlation analysis. A CXCL13 protein-protein interaction (PPI) network was constructed with the STRING website tool and hub genes were screened out. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genome (KEGG) analyses were performed with the "clusterProfiler" R package. Gene set enrichment analysis (GSEA) was used to identify underlying biological mechanisms. A drug-gene interaction network was constructed in the Comparative Toxicogenomics Database (CTD). RESULTS: High CXCL13 mRNA expression were validated in UCEC in the above three independent datasets. High CXCL13 expression was associated with favorable prognosis in UCEC. A nomogram for predicting the 1-, 3-, and 5-year survival probability in UCEC was construct based on CXCL13 expression and other clinical parameters. The use of Spearman correlation indicated certain correlation between CXCL13 and immune cells and immune checkpoint (ICP) genes. Seven hub genes were upregulated in UCEC, namely CXCL9, IFNG, CXCL10, CXCL11, GBP5, CCL18, and GZMB. The expression and prognostic relevance of CXCL9, IFNG, GBP5, and GZMB were in accordance with CXCL13. The main biological processes enriched were cytokine-cytokine receptor interaction and chemokine signaling pathway. CONCLUSIONS: The above comprehensive analyses suggest that CXCL13 may serve as a potential prognostic biomarker for UCEC, specifically for early-stage UCEC.

CXCL13↗
PubMed1975

Prognosis of right bundle branch block and left anterior hemiblock after intracardiac repair of tetralogy of Fallot.

One hundred and forty-one survivors of intracardiac repair of tetralogy of Fallot (TOF), operated on between 1958 and 1972, were studied in order to document the incidence of right bundle branch block and left anterior hemiblock (RBBB and LAH) and to definite the late prognosis. RBBB and LAH occurred in 31 patients (22 per cent), all of whom have had complete follow-up. Transient complete heart block (CHB) occurred postoperatively in 2 patients; there were no other significant arrhythmias. Two late deaths have occurred, neither from arrhythmia (one from progressive congestive heart failure, and the other from attempted reclosure of a ventricular septal defect). The remainder of the patients are well an average of 76 months postoperatively (range, 144 to 12 months). The absence of late-onset CHB or sudden death in this series contrasts with the relatively high incidence of these events in some studies of RBBB and LAH after intracardiac repair of TOF. However, in those reports a history of transient postoperative CHB (indicative of trifascicular disease in this setting) can be found in 75 per cent of those who developed late-onset CHB or died suddenly. We conclude that the occurrence of RBBB and LAH after intracardiac repair of TOF does not of itself carry a bad late prognosis. The critical factor in a bad late prognosis in patients with ECG evidence of RBBB and LAH may be with ECG evidence of RBBB and LAH may be the history of transient postoperative CHB.

Adolescent↗
PubMed1982

Continuous electrocardiographic monitoring in patients with unstable angina pectoris: Identification of high-risk subgroup with severe coronary disease, variant angina, and/or impaired early prognosis.

We assessed the value of two-channel Holter monitoring during the initial hours of hospitalization in patients with unstable angina pectoris (UAP) to identify those with severe coronary artery disease (CAD), variant angina, and/or poor prognosis over the next 3 months. Accordingly, 116 UAP patients had Holter monitoring for 27 +/- 7 (mean +/- SD) (range 12 to 50) hours following hospitalization. Of these, 24 evolved myocardial infarction (MI) during monitoring and 92 did not. Transient ST segment alterations occurred in 21 of the 92. Of these 21, 4 had variant angina, were treated with calcium antagonists, and did well. Each of the remaining 17 had severe fixed CAD (left main or three-vessel) (n = 12) and/or poor prognosis over the 3 months after discharge as manifested by death (n = 1), MI (n = 3), and/or severe angina (n = 3). In contrast, 71 patients did not demonstrate transient ST segment alterations: none had variant angina (p less than 0.001), nine had left main or three-vessel CAD (p less than 0.001), and 50 were alive and well 3 months after discharge (p less than 0.001). Ventricular tachycardia (VT) was demonstrated by Holter monitor in 5 of the 92 patients: four had three-vessel CAD and the other had severe persistent angina. Thus in patients hospitalized with unstable angina, transient ST segment alterations and/or VT on Holter monitor are specific predictors of "high-risk" subgroup UAP patients with left main or three-vessel CAD, variant angina, and/or impaired 3-month prognosis.

Aged↗
PubMed1987

Long-term prognosis of patients with acute myocardial infarction: is mortality and morbidity as low as the incidence of ischemic heart disease in Japan.

Long-term prognosis of hospital survivors with myocardial infarction (MI) was investigated to assess the validity of previous reports on the low incidence of ischemic heart disease in Japan. Among 686 patients with acute MI, 115 (16.8%) died during hospitalization and eight were lost to follow-up. The cumulative mortality rate of the 563 hospital survivors was 6.2% in the first year, 12.0% in the third year, and 19.1% in the fifth year, with cardiac death accounting for 63% of the deaths. Cumulative rates for recurrent MI were 4.4% in the first year, 11.0% in the third year, and 13.2% in the fifth year. Parameters influencing long-term mortality rates obtained by stepwise discriminant analysis were arteriosclerosis-related factors, presence of congestive heart failure at admission, age, and presence of previous MI, while parameters influencing the recurrence of MI were congestive heart failure, arteriosclerosis-related factors, and ischemic findings at discharge. Our findings indicate that the prognosis for patients with MI is far better in Japan than in Western countries and support the previous reports on the low incidence of ischemic heart disease in Japan, while factors influencing the prognosis are similar to those previously reported.

Adult↗
PubMed1993

Preexisting cardiovascular conditions and long-term prognosis after initial myocardial infarction: the Framingham Study.

Preexisting cardiovascular conditions (angina pectoris, intermittent claudication, stroke or transient ischemic attack, and congestive heart failure) were evaluated in relation to long-term prognosis after an initial MI in 828 subjects from the Framingham Heart Study. Preexisting angina pectoris and intermittent claudication in men were associated with increased risk of coronary mortality and recurrent MI, whereas congestive heart failure increased coronary mortality. In women, prior angina pectoris increased the risk of recurrent MI and congestive heart failure increased the coronary mortality. Adjusting for the major cardiovascular risk factors measured before MI, these results held for men but no significant adverse effects persisted in women. Among subjects who survived to return for subsequent examinations, only prior congestive heart failure in men increased the risk after adjusting for post-MI risk factors. In women who returned, angina pectoris and intermittent claudication were associated with poor post-MI prognosis. These results suggest that atherosclerosis is a diffuse disease of the circulatory system, and one in which post-MI prognosis is influenced by the presence of other preexisting cardiovascular conditions. Hence a patient who has an MI after prior expression of cardiovascular disease requires more vigorous preventive management.

Aged↗
PubMed1982

Long-term prognosis in patients with bundle branch block complicating acute anteroseptal infarction.

In a previous study patients with bundle branch block complications acute anteroseptal infarction found to have a high incidence rate of sudden death and late ventricular fibrillation in the first 6 weeks after infarction. Forty-two such consecutive patients were therefore kept within the monitoring area during those 6 weeks. Eighteen (43 percent) of these 42 patients survived and were then followed up for an average of 13 months to assess long-term prognosis and to evaluate whether the in-hospital monitoring period should be extended over 6 weeks. In most of these 18 patients a bifascicular block developed in the acute stage of infarction and in 3 it progressed to transient high degree atrioventricular (A-V) block. Seven of the 18 survivors had potentially lethal complications during the first 6 weeks. Four of these seven underwent aneurysmectomy between 10 and 20 weeks after infarction, and one of them died of a surgical complication. Major cardiac events occurred in 3 of the 17 survivors. None of these patients died during the follow-up period. In one patient complete A-V block developed after aneurysm resection; this was the only patient treated with permanent pacing. Fifteen of the 17 patients were in functional class I or II. These results indicate that (1) patients with bundle branch block complicating acute anteroseptal infarction who survive the first 6 weeks after infarction have a good prognosis during the 1st year, and (2) extension of the in-hospital monitoring period is not necessary. The results further suggest that prophylactic permanent pacing does not affect prognosis in these patients.

Bundle-Branch Block↗
PubMed1988

Detection and prognosis of the asymptomatic patient with silent myocardial ischemia.

Detection of asymptomatic silent ischemia relies mainly on exercise screening procedures in (1) selected patient subgroups with increased likelihood of having latent coronary artery disease and (2) patients after infarction with uncomplicated courses. Prognosis in these patients varies, depending on the extent of disease and left ventricular dysfunction. The worst prognosis is found in patients with prior infarctions, 3-vessel disease and poor exercise tolerance. Prognosis is excellent in totally asymptomatic patients with only 1-vessel disease and good ventricular function.

Adult↗
PubMed1985

Course and prognosis of sarcoidosis in a nonreferral setting. Analysis of 86 patients observed for 10 years.

Analysis of the course and prognosis of 86 patients with sarcoidosis over a 10-year period of observation in a nonreferral setting (Kaiser-Permanente Medical Care Program), a prepaid health maintenance organization, revealed no deaths or severe disability due to respiratory failure or cor pulmonale among 12 patients in whom pulmonary fibrosis either was present or developed during the period of observation. The prognosis by stage and overall was not influenced by race. Because of the method of disease identification that was chosen, it is believed the favorable outcome observed more closely approximates the course and prognosis of sarcoidosis as it occurs in the population in general than do series emanating from institutional settings.

Adult↗
PubMed1985

Long-term follow-up of patients with Crohn's disease. Relationship between the clinical pattern and prognosis.

In a study of 615 new patients with Crohn's disease consecutively diagnosed at the Cleveland Clinic between 1966 and 1969, 592 patients were observed (mean greater than 13 yr, minimum 7 yr), giving a follow-up rate of 96.3%. The original hypothesis was that initial anatomic involvement (the clinical pattern) bears directly on clinical course and prognosis. Disease sites were as follows: 246 ileocolic, 165 small intestine, and 181 colon/anorectal. Among patients with ileocolic disease, 225 (91.5%) had surgery. For the small intestine pattern, the operative incidence was 65.5%; for the colon/anorectal pattern, it was 58%. Operations were for specific reasons: internal fistula with abscess or intestinal obstruction for ileocolic pattern; intestinal obstruction for small intestine pattern; and severe perianal disease or toxic megacolon for colon/anorectal pattern. Complications among nonoperated patients included perianal fistulas and extraintestinal manifestations. No statistical correlation existed between type and duration of medical treatment and prognosis. Seventy-five deaths occurred (12.8%), 36 of which related directly to Crohn's disease. Even after many years, symptoms continued and quality of life tended to be suboptimal among operated patients. For nonoperated patients, the most favorable quality of life was experienced by those with segmental involvement of the colon or ileum. Poor prognosis correlated with ileocolic disease and presence of sepsis because of an internal fistula.

Adult↗
PubMed1989

Early indicators of prognosis in fulminant hepatic failure.

The successful use of orthotopic liver transplantation in fulminant hepatic failure has created a need for early prognostic indicators to select the patients most likely to benefit at a time when liver transplantation is still feasible. Univariate and multivariate analysis was performed on 588 patients with acute liver failure managed medically during 1973-1985, to identify the factors most likely to indicate a poor prognosis. In acetaminophen-induced fulminant hepatic failure, survival correlated with arterial blood pH, peak prothrombin time, and serum creatinine--a pH less than 7.30, prothrombin time greater than 100 s, and creatinine greater than 300 mumol/L indicating a poor prognosis. In patients with viral hepatitis and drug reactions three static variables [etiology (non A, non B hepatitis or drug reactions), age less than 11 and greater than 40 yr, duration of jaundice before the onset of encephalopathy greater than 7 days] and two dynamic variables (serum bilirubin greater than 300 mumol/L and prothrombin time greater than 50 s) indicated a poor prognosis. The value of these indicators in determining outcome was tested retrospectively in a further 175 patients admitted during 1986-1987, leading to the construction of models for the selection of patients for liver transplantation.

Acetaminophen↗
PubMed1987

The classification and prognosis of epiphyseal injuries.

Because of the difficulty of assessing prognosis, a clinical and radiological review of 103 injuries of growth plates was performed. Thirteen patients showed retardation of growth and in 4 it was clinically obvious. In addition, external deformity occurred because of failure of remodelling in 1 case. In 9 cases there appeared to be slight stimulation of growth. The correlation between the Salter-Harris classification and retardation of growth was not always clear, especially in Salter-Harris type IV injuries, wherein prognosis varied with site. At the distal end of the tibia two groups of type IV injury were identified having respectively a 0 and 62.5 per cent incidence of retardation of growth. A new classification of distal injuries of the tibia is proposed, with superior predictive value for retardation of growth than that of Salter and Harris. This is valuable as a guide to prognosis and may facilitate treatment.

Adolescent↗
PubMed1988

Aortic intimal lipid content and serum lipoproteins in patients undergoing coronary by-pass surgery as related to clinical prognosis.

Intimal lipid concentrations were determined in aortic biopsies obtained during coronary by-pass surgery. In addition serum lipoprotein and apolipoprotein levels were quantitated and their relationships to aortic intimal lipid concentrations were analysed. The possibility to use aortic intimal lipid and serum lipoprotein or apolipoprotein concentrations to predict clinical prognosis following the coronary by-pass operation was also evaluated. Intimal cholesterol, cholesterol ester, phosphatidylcholine and sphingomyelin were intercorrelated, whereas none of these lipid fractions correlated to aortic intimal triglyceride levels. Patients with hypertension had higher aortic intimal cholesterol ester levels than normotensive patients. There was a positive correlation between the number of stenosed coronary arteries and serum apo B or triglyceride levels. In addition there was a negative correlation between the number of stenosed arteries and HDL-cholesterol. Prognosis after the operation was inversely correlated to serum apo A-I levels. Our data do not, however, support the notion that aortic intimal lipid levels can be used to evaluate prognosis after coronary by-pass surgery.

Adult↗
PubMed1990

N-myc gene amplification and other prognosis-associated factors in neuroblastoma.

The correlation between N-myc gene amplification and heretofore known prognosis-associated factors was studied in 23 cases of neuroblastoma, comprising a total of 29 tumors (23 primary and six metastatic), examined in and after 1983. DNAs were extracted from tumor tissues preserved at -70 degrees C and digested with the restriction enzyme EcoRI. Southern blotting analysis was performed on these DNAs with the N-myc probe labelled with alpha-32P-dCTP. Prognosis-associated factors studied were age at diagnosis, stage, primary site, histological type, blood biochemistry tests, and catecholamine metabolites in urine. Amplification of N-myc gene was observed only in the cases in which primary site was the adrenal gland, but the relation to the stage, histological type, and prognosis was not as apparent as reported by other investigators. However, the amounts of catecholamine metabolites were low in the cases with amplification, and this suggests immaturity of catecholamine metabolism in the tumor with N-myc gene amplification.

Blotting, Southern↗
PubMed1993

Components of Type A behavior and the first-year prognosis of a myocardial infarction.

This study examined prospectively the role of Type A behavior and its subcomponents in the first-year prognosis of myocardial infarction (MI). Anger expression, irritability, and cynicism were assessed as traits related to the hostility component of the construct. The sample comprised 92 patients, less than 65 yr old, who survived the acute phase of their first MI. Psychological data was collected by self-report questionnaires during the initial hospital stay. Type A behavior was measured by the Jenkins Activity Survey and by the Finnish Type A Scale. Factors were controlled for age, sex, social status, and the MI severity. The results showed that patient who had a reinfarction or died during the first year reported more irritability and experienced anger more often than patients surviving without any complications. From the standard subcomponents only the Speed-Impatience factor of the JAS predicted poor prognosis. Our results indicated that the global Type A scores were not associated with the prognosis of MI.

Achievement↗
PubMed1994

Histopathological classification of childhood rhabdomyosarcomas: relationship with clinical parameters and prognosis.

To define a useful and prognostically relevant classification system for rhabdomyosarcomas (RMSs), tissue sections of 113 well-documented, protocol-treated cases were retrieved from the files of the Emma Kinderziekenhuis Amsterdam, the Netherlands, and reclassified by a panel of pediatric pathologists. The following subtypes were recognized: embryonal RMS (n = 66), alveolar RMS (including the solid variant) (n = 16), botryoid RMS (n = 11), embryonal sarcoma (n = 6), and spindle cell RMS (n = 5). Nine cases were classified as RMS not otherwise specified (NOS). The above-mentioned histopathological subtypes correlated significantly with survival (P = .005) in patients with nonparameningeal tumors. Indeed, the best prognosis was observed in patients with spindle cell RMS, embryonal sarcoma, and botryoid RMS (10-year survival rates of 80% to 86%). Patients with embryonal RMS had an intermediate prognosis (10-year survival rate of 55%) and patients with alveolar RMS fared poorly (10-year survival rate of 9%). Survival rate was poor in patients with a localized parameningeal tumor, irrespective of histopathological subtype (10-year survival rate of 33%). Furthermore, this study confirmed the known impact on prognosis of localization (P = .008) and tumor node metastasis (TNM) stage (P = .0005). Classification of RMS subtypes proved to be fairly well reproducible (kappa ranging from 0.47 to 0.85 and percentage of concordance ranging from 50% to 85%). The best agreement was noted in botryoid RMS and the worst in embryonal sarcoma. However, improvement of agreement was noted for the latter subtype during the consecutive classification sessions. In summary, this study shows the strong prognostic value of histopathological subtypes and parameningeal tumor localization.

Child↗
PubMed1983

Nuclear DNA content of clear cell adenocarcinoma of the vagina and cervix and its relationship to prognosis.

A study was performed to determine if ploidy levels of nuclear DNA content could be used as a prognostic index of the biologic behavior of clear cell adenocarcinoma of the vagina and cervix in young females. Forty tumors were examined. Four patterns of nuclear DNA distribution were identified: (1) peridiploid stem cell lines (2N to 3N); (2) peritetraploid stem cell lines (3N to 5N); (3) hypertetraploid stem cell lines (greater than 5N); and (4) highly aneuploid without detectable stem cell lines. Tumors having peridiploid and peritetraploid stem cell lines (low ploidy group) were most often clinical Stage I or II (87%) and were in general associated with a favorable prognosis. Tumors having hypertetraploid stem cell lines and highly aneuploid distribution (high ploidy group) were usually clinical Stage III or IV (65%). Clinically advanced tumors (Stage III or IV) had poor prognosis irrespective of ploidy level. Among the clinical Stage I and II tumors, the low ploidy group had a slightly better prognosis than the high ploidy group. This difference, however, was not statistically significant.

Adenocarcinoma↗
PubMed1991

Improved prognosis of ovarian cancer in The Netherlands during the period 1975-1985: a registry-based study.

Survival of 568 patients with ovarian cancer, diagnosed in 1975-1985, was studied by means of a population-based registry in the Southeast Netherlands. Patients diagnosed in the period 1981-1985 had a significantly better prognosis than patients diagnosed in 1975-1980. This improvement of survival declined with advancing age of the patients. In women younger than 60 years, mortality from ovarian cancer decreased, while incidence remained stable. Apart from the effect of new treatment methods, consisting of more extensive tumor reduction and cisplatin-based combination chemotherapy, advances in supportive care as well as a trend toward earlier diagnosis, possibly in combination with an increasing proportion of less malignant tumors, may explain the improvement in prognosis. Survival was strongly related to stage at diagnosis and to age, the prognosis of younger patients being more favorable. Patients with tumors of either germ cell or stromal origin generally survived longer than patients with epithelial tumors, but this difference disappeared after adjustment for stage and age. Patients still alive after 6 years did not have a survival significantly different from that of the general female population.

Adolescent↗
PubMed1993

Does pregnancy influence the prognosis of malignant melanoma?

The effect of pregnancy on the clinical course of malignant melanoma (MM) is unclear. Early clinical and laboratory evidence suggested a relation between hormones and MM and subsequently between pregnancy and MM. We reviewed the literature on MM and pregnancy to address three questions: What is the effect on prognosis if an MM is diagnosed during pregnancy? What is the effect of previous pregnancies on the prognosis of MM? What effect does a subsequent pregnancy have on the prognosis of MM? On the basis of a limited number of controlled studies, it does not appear that being pregnant before, after, or at the time of diagnosis of stage I MM influences the 5-year survival rate. However, caution in interpreting these data must be taken because it is possible that the duration of follow-up and size of the study populations are not sufficient to observe a true effect.

Adolescent↗