scholarly journals Establish a Scoring Model for High-Risk Population of Gastric Cancer and Study on the Pattern of Opportunistic Screening

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Wei Tao ◽  
Hai-Xia Wang ◽  
Yu-Feng Guo ◽  
Li Yang ◽  
Peng Li
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Logistic Regression ◽  
High Risk ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Opportunistic Screening ◽  
Scoring Model ◽  
High Risk Factors ◽  
Risk Scoring

Objective. To investigate and study the related risk factors of gastric cancer (GC) patients, to establish a high-risk scoring model of GC by multiple logistic regression analysis, and to explore the establishment of a GC screening mode with clinical opportunistic screening as the main method, and by using the pattern of opportunistic screening to establish the screening of high-risk GC patients and the choice of screening methods in the clinical outpatient work. Methods. Collected the epidemiological questionnaire of 99 GC cases and 284 non-GC patients (other chronic gastric diseases and normal) diagnosed by the General Hospital of Ningxia Medical University from October 2017 to March 2019. Serum pepsinogen (PG) levels were measured by enzyme-linked immunosorbent assay (ELISA) and confirmed Helicobacter pylori (Hp) infection in gastric mucosa tissues by Giemsa staining. Determined the high-risk factors and established a scoring model through unconditional logistic regression model analysis, and the ROC curve determined the cut-off value. Then, we followed up 26 patients of nongastric cancer patients constituted a validation group, which validated the model. Results. The high-risk factors of GC included age≥55, male, drinking cellar or well water, family history of GC, Hp infection, PGI≤43.6 μg/L, and PGI/PGII≤2.1. Established the high-risk model: Y=A×age+30×gender+30×drinking water+30×Hp infection+50×family history of GC+B×PG level. The ROC curve determined that the cut-off value for high-risk GC population was ≥155, and the area under the curve (AUC) was 0.875, the sensitivity and specificity were 87.9% and 71.5%. Conclusions. According to the risk factors of GC, using statistical methods can establish a high-risk scoring model of GC, and the score≥155 is divided into the screening cut-off value for high-risk GC population. Using this model for clinical outpatient GC screening is cost-effective and has high sensitivity and specificity.

scholarly journals The Efficacy of Risk Score System Establishment and Methylprednisolone Stratification Treatment for Pre-Engraftment Syndrome after Unrelated Cord Blood Transplantation: A Retrospective (development) and a Prospective (validation) Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4501-4501
Author(s):  
Xiaoyu Zhu ◽  
Jiang Zhu ◽  
Baolin Tang ◽  
Kaidi Song ◽  
Linlin Jin ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Score ◽  
Cumulative Incidence ◽  
Scoring System ◽  
Cord Blood Transplantation ◽  
High Risk Factors ◽  
Risk Scoring ◽  
Risk Scoring System ◽  
Different Doses

Introduction Pre-engraftment syndrome (PES) is a common immune reaction prior to neutrophil engraftment after unrelated cord blood transplantation (UCBT), with a unique clinical manifestation of non-infectious fever and skin rash. The reported incidence of PES ranges from 20% to 78%. Although many researchers believe that PES is associated with a high incidence of acute graft-versus-host disease (GVHD) but not with transplant-related mortality (TRM) , relapse, or overall survival (OS), they did not stratify the risk factors of PES, and how to carry out different doses of methylprednisolone (MP) stratified intervention therapy still remains unknown. Method s First, 136 hematological malignancy patients treated with UCBT from April 2000 to February 2012 in our transplantation center were retrospectively analysis. Among them, 92 patients occurred PES. High-risk factors for 180-day TRM in PES patients were established by univariate and multivariate analysis. Then, from January 2013 to August 2016, 221 PES patients were scored according to the risk scoring system and stratified treated with different doses of MP. Finally, in order to validate the efficacy of MP stratification treatment, we conducted a prospective, open label and non-randomized clinical trial including 240 PES patients who underwent UCBT from September 2016 to December 2018. This trial is registered at www.chictr.org.cn as ChiCTR-ONC-16009013. Results The cumulative incidence of neutrophil and platelet engraftment was significantly higher in PES group than non-PES group (97.8% vs 70.5%, P<0.001; 75.0% vs 54.5%, P=0.05). In 92 PES patients, multivariate analysis showed that failed MP treatment, multiple clinical symptoms and early onset of PES were independent high risk factors affecting180-day TRM. One high risk factor was scored as 1. The 92 PES patients were divided into PES-0, PES-1,PES-2 and PES-3, and the higher the score, the higher the TRM (17.7% vs 21.9% vs 62.5% vs 100%,respectively; P<0.001), and the lower the OS (68.3% vs 56.2% vs 25.0% vs 0%, respectively; P<0.001). Then, from January 2013 to August 2016, 221 PES patients were scored as PES-0, PES-1 and PES-2 according to the following two high risk factors (multiple clinical symptoms and early onset of PES) and stratified treated with different doses of MP (0.5mg/kg/d for PES-0, 1mg/kg/d for PES-1 and 2mg/kg/d for PES-2). Compared to the previous PES patients with the same risk score, the 180-day TRM of PES-1 and PES-2 patients was significantly reduced and the OS, disease free survival (DFS), and GVHD-free and Relapse-free survival (GRFS) were significantly increased after stratified treatment. The results in the prospective trial were similar to the retrospective study. In addition, although stratified therapy could significantly improve the prognosis of PES-2 patients cohort, the cumulative incidence of acute GVHD and GRFS are still the worst compared with other risk score patients. Therefore, how to improve the outcomes of PES-2 patients remains to be further studied. Conclusion s PES after UCBT is benefit for engraftment, but should be graded according the risk scoring system. Different doses of MP stratified intervention therapy can significantly improve the prognosis of severe PES patients. The risk scoring system of PES after UCBT and MP stratification treatment are worthy of clinical application. But the cumulative incidence of acute GVHD and GRFS in severe PES patients still need to be ameliorated in the further study. Disclosures No relevant conflicts of interest to declare.

scholarly journals Risk scoring model to predict recurrence in locally advanced breast cancer (LABC) treated with neoadjuvant chemotherapy (NACT).

2019 ◽  
Vol 5 (suppl) ◽  
pp. 98-98
Author(s):  
Sushma Agrawal ◽  
Prabhakar Mishra ◽  
Punita Lal ◽  
Gaurav Agarwal ◽  
Amit Agarwal ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Group ◽  
Locally Advanced ◽  
High Risk Group ◽  
Low Risk ◽  
Scoring Model ◽  
Group Score ◽  
Risk Scoring ◽  
Independent Risk Factors

98 Background: Complete response (CR) to NACT portends favorable long term outcomes in LABC. There is a need for a tool to risk categorise patients for recurrence risk (RR), so that intensification of treatment can be offered to women with high risk of recurrence. Methods: A prospectively maintained database of LABC (between January 2007 to December 2012), who received NACT followed by definitive surgery, radiotherapy and endocrine therapy in endocrine sensitive disease was retrospectively analyzed for clinico-pathological and treatment factors affecting disease free survival (DFS). A risk scoring model was developed on the basis of beta coefficients of identified independent risk factors for DFS. Results: The incidence of loco-regional relapse was 8% and that of distant metastases was 32% in a dataset of 206 patients at a median follow-up of 47 months (IQR 24-62 mo). The independent risk factors for recurrence were index T stage [HR 1.8 (0.9-3.6)], N stage [HR 1.7 (0.4 – 4.7)], grade [HR 1.8 (0.8-4.2)], age less than and more than 40 years [HR 1.6 (0.4-0.9)], pathologic CR [HR 4.3 (1.7- 10.7)], intrinsic subtype [HR 2.2 (1.3-3.7)], and type of surgery (BCS vs MRM) [HR 2.2 (1.3-3.6)]. The ROC of the model for the prediction of recurrence was 0.67 (95 % CI: 0.61-0.75). The results of this model were validated by dividing the population into 3 risk groups: low risk (score less than 12), intermediate risk group (score between 13-15), high risk group (score 16 or more). The chances of recurrence are 16% versus 34% versus 57% in low, intermediate and high risk group respectively. Presence of three risk factors implies low risk, five intermediate and more than five high risk. Conclusions: The risk scoring model developed by us predicts RR and can be used for selecting patients for treatment intensification in high risk category.

scholarly journals Tumor Characteristics Predicting Perineural Invasion in Cutaneous Squamous Cell Carcinoma Identified by Stepwise Logistic Regression Analysis

2018 ◽  
Author(s):  
Brandon T Beal ◽  
Maulik M Dhandha ◽  
Melinda B Chu ◽  
Vamsi Varra ◽  
Eric S Armbrecht ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Logistic Regression ◽  
High Risk ◽  
Cell Carcinoma ◽  
Perineural Invasion ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Stepwise Logistic Regression ◽  
Factors Associated ◽  
High Risk Factors

Background: Perineural invasion (PNInv) is a significant risk factor for metastasis and death in cutaneous squamous cell carcinoma (cSCC).  Despite this known association, factors contributing to the presence of PNInv are not well characterized.Aims: To determine risk factors associated with the presence of PNInv using the high-risk cSCC criteria developed by the National Comprehensive Cancer Network (NCCN).Methods: After receiving Institutional Review Board approval for this retrospective review, the presence of NCCN high-risk factors for cSCC were recorded for patients treated at a tertiary referral academic medical center, from January 1, 2010 to March 31, 2012. Stepwise logistic regression was used to identify factors associated with the presence of PNInv.Results: PNInv was present in 34 of 507 cSCCs (6.7%). Moderately or poorly differentiated histology (P < .001, OR 6.6 [95% CI, 3.2-13.7]), acantholytic, adenosquamous, or desmoplastic subtype (P =.01, OR 1.8 [95% CI, 0.8-4.2]), and tumors in areas M (≥10mm) and H ( ≥6mm) (P = .05, OR 5.0 [95% CI, 1.2-21.0]) were significantly associated with the presence of PNInv.Conclusions:  This data suggests clinicians should have a higher suspicion and may be able to identify PNInv in high-risk cSCC based on the presence of specific high-risk factors.

scholarly journals A multicenter study assessing the prevalence of germline genetic alterations in Chinese gastric cancer patients

2020 ◽  
Author(s):  
Yinjie Zhang ◽  
Yang Yang ◽  
Qing Wei ◽  
Ting Xu ◽  
Xiaotian Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
High Risk ◽  
Gene Mutations ◽  
Genetic Alterations ◽  
Chinese Patients ◽  
Germline Variants ◽  
High Risk Factors ◽  
Uncertain Significance ◽  
Gastric Cancer Patients

Abstract Background: Approximately 10% of patients with gastric cancer (GC) have a genetic predisposition for the disease. To date, knowledge regarding germline mutations in predisposing genes in the Chinese GC population is scarce. The aim of this study was to determine the spectrum and distribution of predisposing gene mutations among Chinese GC patients known to have hereditary high-risk factors for cancer. Methods: Forty patients from among ten families were recruited from seven medical institutions in China. Next-generation sequencing was performed on 171 genes associated with cancer predisposition. For probands with pathogenic/likely pathogenic germline variants, Sanger sequencing was used to validate the variants in the probands and their relatives. Results: Sequencing indicated that 25% (10/40) of the patients carried a combined total of ten pathogenic or likely pathogenic germline variants involving nine different genes: CDH1 (n = 1), MLH1 (n = 1), MSH2 (n = 1), CHEK2 (n = 1), BLM (n = 1), EXT2 (n = 1), PALB2 (n = 1), ERCC2 (n = 1), and SPINK1 (n = 2). Five of these variants have not previously been reported. In addition, a total of 129 variants of uncertain significance were identified in 27 patients. Conclusions: This study found that 25% of Chinese GC patients with hereditary high-risk factors have deleterious germline alterations. This result may indicate a unique genetic background of GC among Chinese patients.

scholarly journals A multicenter study assessing the prevalence of germline genetic alterations in Chinese gastric cancer patients

2019 ◽  
Author(s):  
Yinjie Zhang ◽  
Yang Yang ◽  
Qing Wei ◽  
Ting Xu ◽  
Xiaotian Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
High Risk ◽  
Gene Mutations ◽  
Genetic Alterations ◽  
Chinese Patients ◽  
Germline Variants ◽  
High Risk Factors ◽  
Uncertain Significance ◽  
Gastric Cancer Patients

Abstract BackgroundApproximately 10% of patients with gastric cancer (GC) have a genetic predisposition for the disease. To date, knowledge regarding germline mutations in predisposing genes in the Chinese GC population is scarce. The aim of this study was to determine the spectrum and distribution of predisposing gene mutations among Chinese GC patients known to have hereditary high-risk factors for cancer. Forty patients from among ten families were recruited from seven medical institutions in China. Next-generation sequencing was performed on 171 genes associated with cancer predisposition. For probands with pathogenic/likely pathogenic germline variants, Sanger sequencing was used to validate the variants in the probands and their relatives.ResultsSequencing indicated that 25% (10/40) of the patients carried a combined total of ten pathogenic or likely pathogenic germline variants involving nine different genes: CDH1 (n = 1), MLH1 (n = 1), MSH2 (n = 1), CHEK2 (n = 1), BLM (n = 1), EXT2 (n = 1), PALB2 (n = 1), ERCC2 (n = 1), and SPINK1 (n = 2). Five of these variants have not previously been reported. In addition, a total of 129 variants of uncertain significance were identified in 27 patients.ConclusionsThis study found that 25% of Chinese GC patients with hereditary high-risk factors have deleterious germline alterations. This result may indicate a unique genetic background of GC among Chinese patients.

scholarly journals Adjuvant chemotherapy provided survival benefit for stage T2N0 gastric cancer with high-risk factors

Neoplasma ◽  
2018 ◽  
Vol 65 (04) ◽  
pp. 592-598
Author(s):  
Z. WANG ◽  
J. YAN ◽  
W. HU ◽  
J. ZHANG ◽  
B. HUO
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Survival Benefit ◽  
High Risk Factors

The risk factors for post-polypectomy bleeding and establishment of a risk-scoring model for small colorectal polyps (<1.5cm) in an ambulatory surgery center: a retrospective analysis

2019 ◽  
Author(s):  
Tiantian Lei ◽  
Hailin Yan ◽  
Qing Lu ◽  
Yilan Wang ◽  
Hongsheng Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Ambulatory Surgery ◽  
Colorectal Polyps ◽  
Endoscopic Polypectomy ◽  
Scoring Model ◽  
Ambulatory Surgery Center ◽  
Multivariable Logistic Regression ◽  
Risk Scoring ◽  
Surgery Center

Abstract Background: As one of the most common complications of colonoscopy, the risk factors of post-polypectomy bleeding (PPB) has been rarely explored in an ambulatory surgery unit. We aim to develop a risk-scoring model to predict the risk of PPB forsmall colorectal polyps (<1.5cm) in an ambulatory surgery unit. Methods: The patients with single small colorectal polyps (<1.5cm) who underwent endoscopic polypectomy in the Ambulatory Surgery Center of our hospital between January 2014 and June 2017 were included and retrospectively reviewed. We analyzed patient’s clinical characteristics, morphological and pathological characteristics of polyps, polypectomy techniques, and the occurrence of PPB. Risk factors of PPB were identified with a multivariable logistic regression model. In addition, a risk-scoring system was developed and validated eventually. Results: Among the 771 patients enrolled, 26 (3.4%) patients suffered PPB. The male gender, elderly age (≥ 60 years), using hot biopsy forceps as polypectomy technique adenoma in histopathology, complicated withhypertension, use of anticoagulant or antiplatelet agents, and early excessive activities significantly increased the risk of PPB (P＜0.05) as indicated by the results of multivariable logistic regression analysis. The area under the ROC curve (AUC) in the model group (0.890) and validation group (0.924) indicated that the risk-scoring model could predict the occurrence of PPB effectively. Conclusions: This risk-scoring method may help to predict the risk of PPB forsmall colorectal polyps, fit well in the Ambulatory Surgery Center, and provide a new approach to help reduce the incidence of hemorrhage after colorectal polypectomy.Trial registration: This study was retrospectively registered and approved by the Ethics Committee of West China Hospital of Sichuan University (IRB number: ChiCTR1800020201).

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