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At least 1,603 records · Page 89Linked to original sources
PubMed2006

[The expression of VEGF-C, VEGFR-3 and its predictive value on lymph node metastasis and prognosis of gastric cancer].

OBJECTIVE: s To investigate the relationship between the expression of VEGF-C, VEGFR-3 and lymph node metastasis (LNM) in the gastric cancer, and explore the role of VEGF-C, VEGFR-3 in the prognosis of gastric cancer. METHODS: Gastric cancer specimens were selected from gastric cancer database from April, 1994 to December, 2003, which were registered and followed up. The specimens were divided into two groups according to LNM existing or not. Immunohistochemistry staining was performed with anti-VEGF-C, anti-VEGFR-3 monoclonal antibody by DAB method. Their effects on prognosis of gastric cancer patients were analyzed by Kaplan-meier, Logistic and Cox Regression methods. RESULTS: In 188 cases of gastric cancer patients, 97 patients presented with LNM and the rest did not. The positive expression rate of VEGF-C, VEGFR-3 in the group without LNM was lower than those in group with LNM, and there was significant difference between the two groups. There was significant difference in the average lymphatic vessel density between the group with LNM and the group without, and the same results were found between the group with positive VEGF-C expression and the group without. CONCLUSIONS: VEGF-C, VEGFR-3 are over-expressed in gastric cancer patients with LNM, and the expression of VEGF-C, VEGFR-3 are important predictors for the prognosis of gastric cancer.

Humans↗
PubMedDate not supplied

Influence of transcatheter arterial chemoembolization on the prognosis after hepatectomy for hepatocellular carcinoma in patients with severe liver dysfunction.

BACKGROUND: The influence of preoperative transcatheter arterial chemoembolization (TACE) on postoperative survival and recurrence of hepatocellular carcinoma (HCC) after resection is still controversial. The effect of preoperative TACE on the prognosis of HCC after hepatectomy in 243 patients with liver dysfunction was evaluated. MATERIALS AND METHODS: Among 243 patients who underwent curative resection of HCC between 1992 and 2005, 124 patients had an indocyanine-green retention rate at 15 min (ICGR15) of <17% (49 underwent TACE), while 119 patients had an ICGR15 of > or =17% (66 underwent TACE). The clinical characteristics, operative results and long-term survival were compared between patients with and without preoperative TACE who had mild or severe liver dysfunction. RESULTS: There was no significant difference in the recurrence-free and overall survival rates between the TACE and no TACE groups with an ICGR15 <17%. Among the 119 patients with an ICGR15 > or =17%, there were no significant differences of preoperative characteristics, operative findings, or histology between the two groups. However, the post-resection disease-free and overall survival rates of 66 patients who underwent TACE were significantly better than those of 53 patients who did not have TACE (p = 0.009 and p = 0.0099, respectively). Using multivariate analysis, preoperative TACE was independently associated with better disease-free and overall survival after resection in patients with an ICGR15 > or =17% (p = 0.0309 and p = 0.0162, respectively). CONCLUSION: Preoperative TACE did not alter the prognosis after resection of HCC in patients with mild liver dysfunction, but it did improve the prognosis of patients with severe liver dysfunction.

Aged↗
PubMed1991

[Retrospective clinical evaluation of prognosis factors in stage D2 prostatic cancer treated with endocrine therapy].

Of 91 patients with prostatic cancer treated at our Department of Urology, from January 1976 through December 1987, 42 cases of stage D2 cancer treated with endocrine therapy were evaluated retrospectively with regard to clinical parameters and prognoses. The patients with marked increase in the level of the prostatic acid phosphatase (PACP), and the lactate dehydrogenase (LDH) in serum, and marked decrease in volume of hemoglobin (Hb) had a poor prognosis. The patients who took a long time to obtain a favorable response to the therapy had a poor prognosis. The response grade in NPCP criteria at 3 months after the initiation of therapy reflected the prognosis, and showed good correlation to the grade of favorable response.

Acid Phosphatase↗
PubMed2006

[Prognosis of surgically treated thymic epithelial tumors].

This study was performed to clarify the prognosis of patients with surgically treated thymic epithelial tumors. The records of 131 patients who underwent surgical treatment during 1985-2005 were retrospectively reviewed. Pathologic review was done according to the WHO classification of tumors of the thymus. Patients characteristics were: 76 male and 55 fimale; average age 53 (range 20-80) years; tumor stage was stage I in 42, stage II in 43, stage III in 23, stage IVa in 15, stage IVb in 1, and thymic carcinoma (squamous cell carcinoma) in 7 based on Masaoka's staging. There were 7 cases of type A, 23 of type AB, 30 of type B1, 27 of type B2, 29 of type B3, and 15 of type C. Surgical procedures performed were 5 partial resections, 5 tumoretomies, 5 thymectomies, 65 extended thymectomies, 4 tumorectomies plus adjunctive resections of surrounding tissue, and 51 extended thymectomies plus tumorectomies plus adjunctive resections of surrounding tissue including the pleura, pericardium, lung, and great vessels. Five-, 10-, and 15-year survival rates by Masaoka stage were 100%, 100%, and 100% in stage I; 100%, 100%, and 87.5% in stage II; 100%, 87.5%, and 87.5% in stage III; 71.1%, 53.3%, and 53.3% in stage IVa; and 42.9%, 42.9%, and 0% in thymic carcinoma. The prognosis of patients with stage IVa and thymic carcinoma was thus significantly poorer compared with that in the other groups. According to the WHO classification, the 5-year survival rate of type A was 100%, and the 5-, 10-, and 15-year survival rates were 100%, 100%, and 100% in type AB; 100%, 100%, and 75.0% in type B1; 92.6%, 86.4%, and 86.4% in type B2; 95.5%, 95.5%, and 81.8% in type B3; and 57.1%, 42.9%, and 0% in type C. The survival rate of patients with type C was the poorest and there was a significant difference between type C and all other groups. The prognosis of patients with thymic epithelial tumors after resection is thought to be determined by histologic classification and clinical invasiveness. In particular, patients with type B3 and type C thymomas should be considered for multidisciplinary treatment.

Adult↗
PubMed2006

[Relationship between the adrenal function and the prognosis of acute respiratory distress syndrome].

OBJECTIVE: To explore the relationship between the adrenal function and the prognosis of acute respiratory distress syndrome (ARDS). METHODS: One hundred and fifty-eight patients with ARDS were enrolled in this study and were divided into two groups based on the prognosis: survival group and death group. Every patient was given one shot of corticotrophin 250 microg intravenously, plasma cortisol level was detected by radio-immunoassay before the shot (T0) and 30 minutes (T30) and 60 minutes (T60) after. And meanwhile the following parameters in the patients were recorded: age, APACH II, heart rate, mean arterial pressure, PaO(2)/FiO(2), arterial pH, hemoglobin, platelets and WBC, the number of failed organ and 28-day mortality. Relative adrenal insufficiency was defined as the difference between T0 and the highest value of T30 or T60 (DeltaTmax) <or= 248.4 nmol/L. RESULTS: The total 28-day mortality was 54.4% (86/158) and the total incidence of relative adrenal insufficiency was 42.7% (68/158). The incidence of relative adrenal insufficiency in death group was significantly higher than that in survival group (62.8% vs 19.4%, P < 0.01). The 28-day mortality in patients complicated with relative adrenal insufficiency was significantly higher than that in those did not (76.5% vs 36.8%, P < 0.001). The area under the ROC curve for DeltaTmax was 0.655. With the multivariate analysis, the number of failed organ and relative adrenal insufficiency were independent risk factors of the death in patients with ARDS. CONCLUSIONS: Adrenal function is valuable in predicting the prognosis of the ARDS.

Adolescent↗
PubMed2006

Overall prognosis in younger patients with colorectal carcinoma.

AIM: Prognosis of colorectal cancer in younger patients is a controversial issue. While survival after curative resection seems not worse than in older patients, few data are available about the overall survival of younger patient with colorectal cancer irrespective of receiving a curative treatment or not. In this study we have reviewed our experience with patients under 45 years of age affected by colorectal cancer. METHODS: A total of 358 patients with colorectal cancer were operated on between 2001 and 2005. Nineteen patients were younger than 45. Schedules were reviewed as to palliative vs curative resection, Duke's classification, tumor grading, and compared with data from patients older than 45. RESULTS: Though no significant difference in survival can be detected after curative resection, fewer patients less than 45 years are eligible to be treated curatively. Significantly worse tumor grading and rates of curative resection make for a poorer prognosis in younger patients when compared with older ones. CONCLUSIONS: Prognosis for colorectal cancer in the overall group of patients less than 45 years is worse than in older patients. Younger patients more frequently present with distant metastases or peritoneal carcinosis which preclude the possibility of a curative treatment.

Adult↗
PubMed1991

[Morphological possibilities for objectification of the prognosis for invasive ductal carcinoma of the breast].

Tissue sections were taken from 187 cases of invasive ductal mammary carcinoma (among them 94 cases with lymph node metastases, average follow-up period being 44 months) and, after Feulgen staining, were investigated by automated microscopic image analysis. A comparison was made, with reference to survival periods, between the relevance to prognosis of nuclear image analysis and results obtained from histopathological grading, according to Bloom and Richardson (1957), as well as findings recorded from image analysis of DNA. Histopathological grading was found to be of poor reproducibility (71.1%). While statistically significant differences were found to exist between survival curves of Grades I and III patients, grading proved to be of minor importance to prognostic assessment of the individual case, with the number of G-II cases being relatively high (42.7%). Results of better reproducibility were achievable from the quantitative morphological method of nuclear image analysis. Its forecasting value with regard to good or poor prognosis was clearly higher than that of histopathological grading, and the number of cases with obscure or dubious prognosis was clearly lower (18.9%). DNA ploidy measurement, using DNA histogram types according to Auer (1980), has proved to be another method by which prognostically favourable and unfavourable cases can be distinguished from each other with statistical significance, though its classification quality (70.5%) still was unambiguously below that achievable by nuclear image analysis (79%).

Adult↗
PubMed2006

[Management and prognosis in stage IV gestational trophoblastic neoplasia patients].

OBJECTIVE: To analyze the management and prognosis in stage IV gestational trophoblastic neoplasia (GTN) patients. METHODS: One thousand one hundred and thirty GTN patients were hospitalized and treated at Peking Union Medical College Hospital from year 1985 to 2004. Ninety-two of them were diagnosed as stage IV of GTN. Retrospective analyses were carried out on these patients in terms of management and prognosis. RESULTS: Of the 92 patients who had undergone treatment, complete remission (CR) was achieved in 33, partial remission in 37, and progress of the disease was seen in 22. Among all the CR patients, three had recurrence later. Thirty-three out of all the patients died during or after treatment. Among the 92 cases, 70 had one or two metastases, of whom 27 had CR, and 20 died. Of the 17 cases who had three metastases, 5 achieved CR, and 10 died. Of the five cases with >or= 4 metastases, one had CR, and three died. The number of metastatic organs was correlated with prognosis (P = 0.034) and death (P = 0.018). CONCLUSIONS: Multi-drug and multi-route chemotherapy and (or) combined surgical intervention may improve the survival rate of the stage IV GTN patients. The management should be individualized for different patients with metastases. With the increase in the number of metastatic organs, the remission rate decreases.

Adult↗
PubMed2007

Beta-catenin expression in relation to genetic instability and prognosis in colorectal cancer.

In the carcinogenesis of colorectal cancer (CRC) genetic instability and dysfunction of the Wnt-signalling pathway play important roles. Most Wnt-signalling dysfunctions lead to the nuclear accumulation of beta-catenin. The aim of the present study was to investigate whether nuclear accumulation of beta-catenin is associated with prognosis and genetic instability. We used immunohistochemistry to study nuclear beta-catenin expression in 67 CRCs. The expression was evaluated in the entire tumour section as mean values and in tumour budding at the invasive margin. We compared the results with chromosomal and microsatellite instability (CIN vs. MSI), p53 accumulation, and clinicopathological variables including survival. The nuclear accumulation of beta-catenin was significantly associated with abnormal p53 expression and aneuploidy, typically for CIN, whereas no tumour with nuclear beta-catenin expression at the invasive margin displayed MSI. The beta-catenin expression pattern did not correlate significantly with CRC patient prognosis when including all stages. However, in the clinically most interesting prognostic group, Dukes' stage B patients, high nuclear accumulation of beta-catenin was associated with a poor prognosis (p=0.01). Our results suggest that nuclear accumulation of beta-catenin in CRC is related to CIN and may be of prognostic importance. However, larger studies are needed to verify these findings.

Aged↗
PubMed1991

Effect of congestive heart failure treatment on incidence and prognosis of ventricular tachyarrhythmias.

The prognosis for patients with congestive heart failure (CHF) is poor, with a mortality exceeding 50% within 5 years from diagnosis. This poor prognosis remains despite improved pharmacological therapy. Because the prevalence of sudden death among these patients is high, reported to exceed 40%, the prognostic importance of ventricular tachyarrhythmias has attracted much interest. Long-term electrocardiographic monitoring of patients with CHF reveals a high prevalence of ventricular premature beats, which in many patients occur frequently or are complex according to Lown criteria. Ventricular tachycardia (three or more consecutive beats) has been recorded in 40% or more of the patient population. Whether the occurrence and/or severity of ventricular tachyarrhythmia detected on Holter electrocardiograms relates to the subsequent prognosis is, however, debated. The occurrence of ventricular tachyarrhythmia may just be an expression of severely compromised left ventricular function, which, in turn, decides the subsequent outcome of the disease. Besides myocardial injury, patients with CHF have many factors that may contribute to the high prevalence of ventricular arrhythmias. Among these are elevated levels of plasma norepinephrine. Angiotensin II may increase the sensitivity to sympathetic nervous system arousal but also promotes renal loss of potassium and magnesium. Treatment with digitalis and diuretic drugs may provoke arrhythmias as well. Heart failure therapy may, however, also improve ventricular arrhythmias. Accordingly, it has been demonstrated that captopril therapy significantly reduces ventricular prematurity, compared with digitalis. In contrast, however, enalapril improvement of mortality was due to a reduction of progressive heart failure, with no difference seen in the incidence of sudden cardiac death (the CONSENSUS study).(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Arrhythmia Agents↗
PubMed1991

The clinical features, course, prognosis and treatment of juvenile arthritis.

The author's classification of juvenile arthritis (JA) differs from most by utilizing both the type of onset and the disease course separated into individual subgroups. The clinical aspects of each are described in detail, along with the special tests and studies to be done to differentiate them. Particular attention is given to the differences between the four subgroups of the pauciarticular onset group. There are different genetic factors for each subgroup and new data on HLA typing utilizing DNA techniques may be helpful in the prognosis of the disease course. The therapy of JA begins with non-steroidal anti-inflammatory drugs, continues with second-line drugs such as gold and penicillamine, and finally leads to the use of immunosuppressive agents. The range of doses, the maximal dose, and the frequency of administration is given for each medication. The long-term prognosis is generally good, with a low death rate, primarily seen in the systemic onset patients. The causes of death vary around the world. Prognosis for continued joint activity and joint function is determined significantly by the type of onset and is worse in the rheumatoid factor positive polyarticular onset group.

Adolescent↗
PubMed1991

[Outcome prognosis in severe craniocerebral trauma: important predictors in the early phase].

An early prognosis may influence the management of severely head-injured patients. Clinical aspects (age, Glasgow Coma Score, pupil reaction) and neuroradiological findings (basal cysternes, midline shift) are the most important facts for prognosis; evoked potentials, stress parameters and the quality of resuscitation also correlate with definitive outcome. Despite a clear correlation between these single factors and outcome, prognosis during the first 48 hours remains too uncertain to justify an influence on initial management.

Aged↗
PubMed1991

[Prognosis and prognostic factors of hemorrhage by rupture of varices in cirrhotic patients in the era of endoscopic sclerotherapy].

The aim of this study was to evaluate the prognosis and the determinants of survival in cirrhotics presenting with variceal bleeding. One hundred and ninety one consecutive patients with cirrhosis (alcoholic 93 percent) were enrolled between 1983 and 1988. Treatment was principally but not exclusively based on early endoscopic sclerotherapy. At admission all patients were classified according to Child-Pugh's classification (class A = 16 percent; class B = 53 percent; class C = 31 percent). The rebleeding rates at 48 hours and for the entire hospitalisation were 11 and 30 percent respectively. Actuarial survival rates were 45, 40, and 37 percent at 12, 18, and 36 months, respectively. Prognostic factors, as determined by uni- and multivariate analysis (Cox model), corresponded to Child-Pugh's score, to the five components, and the occurrence of early bleeding recurrence. This study also showed that: i) the role of Child-Pugh's classification on long-term prognosis is determined during the 3 months following index bleeding; ii) early rebleeding is a significant prognostic factor, particularly in Child-Pugh's class B patients; iii) there are few indicators of early rebleeding (serum albumin level, presence of gastric varices at initial endoscopy). Prognosis of variceal bleeding is still severe in cirrhosis but efforts made to prevent early bleeding recurrence seem to be fully justified.

Actuarial Analysis↗
PubMed1991

DNA ploidy status in the diagnosis and prognosis of cancer.

DNA ploidy status of tumour cells is becoming a part of patient's record, because it brings an objective assessment of diagnostic and prognostic significance. DNA ploidy status in diagnosis--DNA ploidy status of some tumour types can be used as an adjunct to cytologic or histologic examination and provide an additional diagnostic information. For example, small cell lung carcinoma cells may be difficult to differentiate from cells of other benign neuroendocrine tumours. By computing the DNA malignancy grade, as defined by Bocking A. et al., it was possible to distinguish levels of malignancy among neuroendocrine tumours. Thus we were able to demonstrate that typical carcinoids may be differentiated from small cell carcinomas and atypical carcinoids. DNA ploidy status in prognosis--A large number of studies strongly support a correlation between DNA ploidy patterns and clinical course of malignant tumours. However, the prognostic value of DNA ploidy status has to be evaluated in relation to conventional clinico-pathologic characteristics, by multivariate analysis in order to demonstrate its independent contribution. For example, we demonstrated, in a prospective study of 211 colorectal adenocarcinomas, that ploidy status was an independent predictor of prognosis only in the early stages of the disease (Dukes' A, B, C), but not when advanced stages-(Dukes' D) were considered. In conclusion, DNA ploidy status may be used as an important objective parameter either in diagnosis or in prognosis, complementary to the traditional clinico-pathological characteristics.

DNA, Neoplasm↗
PubMed1991

Development of the low-T3-syndrome and prognosis assessment in patients with liver cirrhosis.

The aim of our study is to prove whether the development of the low-T3-syndrome in patients with liver cirrhosis is associated with their prognosis. For this purpose we determined the peripheral thyroid hormone levels in 28 patients with liver cirrhosis. For prognosis assessment we calculated the Prognostic Index (PI) on the basis of Cox's regression model as recently described by us. Calculating this index we used 11 parameters: liver morphology, consciousness, spider naevi, PCV, thrombocytes, gamma-GT, cholesterol, albumin, Quick's value, IgA, and potassium. It is demonstrated that there is an inverse correlation between T3-serum levels and PI (p = 0.03). An association could not be detected neither between reverse T3 and PI nor between T3 and rT3. On the other hand basal TSH was also inversely associated with PI. Thus, the low T3-serum levels did not induce a rise of basal TSH in cirrhotics. Moreover, the mean serum-T3-concentration differed significantly from that of 6 decreased patients and from that of the surviving (p = 0.00076). It seems to be true that low T3-serum levels are a very sensitive parameter for prognosis prediction in patients with liver cirrhosis.

Female↗
PubMed1991

Multifactorial analysis in the prognosis of ischemic cerebrovascular accidents.

An attempt to determine the prognosis of an individual patient with ischemic cerebrovascular accident means an attempt to take into consideration several parameters at the same time. Discrimination analysis was done as a retrospective study of 316 patients, who were followed from the moment of accident (admitted to the clinic within 24 hours), to four weeks after the accident. Nineteen parameters were determined by degree and correlated with the outcome through statistical significance of a single parameter p less than 0.05). After that, the parameters with statistical significance (age, state of consciousness, severity of motor deficit, previous episodes of cerebrovascular disease, Babinski sign, conjugate deviation of eyes, the way of onset of the disease) were used in a multifactorial analysis. The first analysis referred to the prognosis of survival (76 patients died, 240 patients survived). It was shown that the chosen parameters were satisfactory, since in 87% of cases they divided groups in an appropriate way, i.e. the group of deceased patients amounted to 76% and for the group of survived patients the score amounted to 90%. The second analysis referred only to patients who survived, with the aim to determine the probability of the quality outcome prognosis. It was shown that the same parameters were less reliable and the classification into two groups was done in 76% of cases (for--no deficit or small deficit group--in 73% of cases and for--severe deficit group--in 84% of cases.

Brain Ischemia↗
PubMed1991

[Multiple discriminant analysis for prognosis of refractory anemia].

Forty-eight patients with refractory anemia (RA) were retrospectively analyzed for their prognosis and subclassified into three groups: 12 patients with hematological improvement (A), 23 patients with no changes (B), and 13 patients with progression to RAEB or acute leukemia (C). For all patients, the median survival were 49.2 months, and the rate of leukemic transformation was 16%. The median survivals were 60.6, 32.1, and 17.9 months, respectively, for groups A, B and C. The factors indicating poor prognosis were low reticulocyte counts, low neutrophil alkaline phosphatase activity, low% red cell utilization, high M/E ratio, high blast percentage in the bone marrow and cytological abnormalities in the granulocyte and megakaryocyte series. By using multiple discriminant analysis, we obtained a formula for the prognostic estimation with a discrimination probability of 62.5%. This formula could predict either the patients with good (Y greater than 0.85) or poor (Y less than 0.59) prognosis, and might be useful to select the treatment for this intractable anemia at the time of diagnosis.

Adolescent↗
PubMed1991

[Oncogene and patient prognosis].

The common malignancies apparently develop by a stepwise accumulation of gene alterations including oncogenes and suppressor genes. Point mutation or deletion might be an early event for carcinogenesis and tumor progression, while amplification of several oncogenes occur as a late event. Amplification of some oncogenes apparently relate with patient prognosis, i.e. erbB2 for breast, ovarian and gastric carcinomas, HST-1/INT-2 for esophageal and breast carcinomas, and N-myc for neuroblastoma. Although amplification of erbB1 is less common, its expression indicate poorer prognosis in patients with esophageal, gastric and bladder carcinomas. Combination analysis of the gene amplification and other gene alterations, such as p53 gene might provide more useful clinical informations for the postoperative management and prognosis of cancer patients.

Breast Neoplasms↗