Prediction Model of HBsAg Seroclearance in Patients with Chronic HBV Infection

Background. Prediction of HBsAg seroclearance, defined as the loss of circulating HBsAg with or without development of antibodies for HBsAg in patients with chronic hepatitis B (CHB), is highly difficult and challenging due to its low incidence. This study is aimed at developing and validating a nomogram for prediction of HBsAg loss in CHB patients. Methods. We analyzed a total of 1398 patients with CHB. Two-thirds of the patients were randomly assigned to the training set (n=918), and one-third were assigned to the validation set (n=480). Univariate and multivariate analysis by Cox regression analysis was performed using the training set, and the nomogram was constructed. Discrimination and calibration were performed using the training set and validation set. Results. On multivariate analysis of the training set, independent factors for HBsAg loss including BMI, HBeAg status, HBsAg titer (quantitative HBsAg), and baseline hepatitis B virus (HBV) DNA level were incorporated into the nomogram. The HBsAg seroclearance calibration curve showed an optimal agreement between predictions by the nomogram and actual observation. The concordance index (C-index) of nomogram was 0.913, with confirmation in the validation set where the C-index was 0.886. Conclusions. We established and validated a novel nomogram that can individually predict HBsAg seroclearance and non-seroclearance for CHB patients, which is clinically unprecedented. This practical prognostic model may help clinicians in decision-making and design of clinical studies.

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A novel ferroptosis-related genes model for prognosis prediction of lung adenocarcinoma

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01588-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fei Li ◽

Dongcen Ge ◽

Shu-lan Sun

Keyword(s):

Regression Analysis ◽

High Risk ◽

Prediction Model ◽

Cox Regression ◽

Risk Group ◽

Training Set ◽

Cox Regression Analysis ◽

Key Genes ◽

Validation Set ◽

Prognostic Prediction

Abstract Background Ferroptosis is a newly discovered form of cell death characterized by iron-dependent lipid peroxidation. This study aims to investigate the potential correlation between ferroptosis and the prognosis of lung adenocarcinoma (LUAD). Methods RNA-seq data were collected from the LUAD dataset of The Cancer Genome Atlas (TCGA) database. Based on ferroptosis-related genes, differentially expressed genes (DEGs) between LUAD and paracancerous specimens were identified. The univariate Cox regression analysis was performed to screen key genes associated with the prognosis of LUAD. LUAD patients were divided into the training set and validation set. Then, we screened out key genes and built a prognostic prediction model involving 5 genes using the least absolute shrinkage and selection operator (LASSO) regression with tenfold cross-validation and the multivariate Cox regression analysis. After dividing LUAD patients based on the median level of risk score as cut-off value, the generated prognostic prediction model was validated in the validation set. Moreover, we analyzed the somatic mutations, and estimated the scores of immune infiltration in the high-risk and low-risk groups. Functional enrichment analysis of DEGs was performed as well. Results High-risk scores indicated the worse prognosis of LUAD. The maximum area under curve (AUC) of the training set and the validation set in this study was 0.7 and 0.69, respectively. Moreover, we integrated the age, gender, and tumor stage to construct the composite nomogram. The charts indicated that the AUC of LUAD cases with the survival time of 1, 3 and 5 years was 0.698, 0.71 and 0.73, respectively. In addition, the mutation frequency of LUAD patients in the high-risk group was significantly higher than that in the low-risk group. Simultaneously, DEGs were mainly enriched in ferroptosis-related pathways by analyzing the functional results. Conclusions This study constructs a novel LUAD prognosis prediction model involving 5 ferroptosis-related genes, which can be used as a promising tool for decision-making of clinical therapeutic strategies of LUAD.

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Immune-related lncRNAs as predictors of survival in breast cancer: a prognostic signature

Journal of Translational Medicine ◽

10.1186/s12967-020-02522-6 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Wei Ma ◽

Fangkun Zhao ◽

Xinmiao Yu ◽

Shu Guan ◽

Huandan Suo ◽

...

Keyword(s):

Breast Cancer ◽

Regression Analysis ◽

Cox Regression ◽

Risk Group ◽

Curve Analysis ◽

Time Dependent ◽

Training Set ◽

Roc Curve Analysis ◽

Cox Regression Analysis ◽

Validation Set

Abstract Background Breast cancer is a highly heterogeneous disease, this poses challenges for classification and management. Long non-coding RNAs play acrucial role in the breast cancersdevelopment and progression, especially in tumor-related immune processes which have become the most rapidly investigated area. Therefore, we aimed at developing an immune-related lncRNA signature to improve the prognosis prediction of breast cancer. Methods We obtained breast cancer patient samples and corresponding clinical data from The Cancer Genome Atlas (TCGA) database. Immune-related lncRNAs were screened by co-expression analysis of immune-related genes which were downloaded from the Immunology Database and Analysis Portal (ImmPort). Clinical patient samples were randomly separated into training and testing sets. In the training set, univariate Cox regression analysis and LASSO regression were utilized to build a prognostic immune-related lncRNA signature. The signature was validated in the training set, testing set, and whole cohorts by the Kaplan–Meier log-rank test, time-dependent ROC curve analysis, principal component analysis, univariate andmultivariate Cox regression analyses. Results A total of 937 immune- related lncRNAs were identified, 15 candidate immune-related lncRNAs were significantly associated with overall survival (OS). Eight of these lncRNAs (OTUD6B-AS1, AL122010.1, AC136475.2, AL161646.1, AC245297.3, LINC00578, LINC01871, AP000442.2) were selected for establishment of the risk prediction model. The OS of patients in the low-risk group was higher than that of patients in the high-risk group (p = 1.215e − 06 in the training set; p = 0.0069 in the validation set; p = 1.233e − 07 in whole cohort). The time-dependent ROC curve analysis revealed that the AUCs for OS in the first, eighth, and tenth year were 0.812, 0.81, and 0.857, respectively, in the training set, 0.615, 0.68, 0.655 in the validation set, and 0.725, 0.742, 0.741 in the total cohort. Multivariate Cox regression analysis indicated the model was a reliable and independent indicator for the prognosis of breast cancer in the training set (HR = 1.432; 95% CI 1.204–1.702, p < 0.001), validation set (HR = 1.162; 95% CI 1.004–1.345, p = 0.044), and whole set (HR = 1.240; 95% CI 1.128–1.362, p < 0.001). GSEA analysis revealed a strong connection between the signature and immune-related biological processes and pathways. Conclusions We constructed and verified a robust signature of 8 immune-related lncRNAs for the prediction of breast cancer patient survival.

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FAM225B Is a Prognostic lncRNA for Patients with Recurrent Glioblastoma

Disease Markers ◽

10.1155/2020/8888085 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Junsheng Li ◽

Qian Zhang ◽

Peicong Ge ◽

Chaofan Zeng ◽

Fa Lin ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Value ◽

Cox Regression ◽

Recurrent Glioblastoma ◽

Regulation Of Transcription ◽

Training Set ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Validation Set ◽

Pathway Analyses

Objective. The overall survival of patients with recurrent glioblastoma (rGBM) is quite different, so clinical outcome prediction is necessary to guide personalized clinical treatment for patients with rGBM. The expression level of lncRNA FAM225B was analyzed to determine its prognostic value in rGBMs. Methods. We collected 109 samples of Chinese Glioma Genome Atlas (CGGA) RNA sequencing dataset and divided into training set and validation set. Then, we analyzed the expression of FAM225B, clinical characteristics, and overall survival (OS) information. Kaplan-Meier survival analysis was used to estimate the OS distributions. The prognostic value of FAM225B in rGBMs was tested by univariate and multivariate Cox regression analyses. Moreover, we analyzed the biological processes and signaling pathways of FAM225B. Results. We found that FAM225B was upregulated in rGBMs ( P = 0.0009 ). The expression of FAM225B increased with the grades of gliomas ( P < 0.0001 ). The OS of rGBMs in the low-expression group was significantly longer than that in the high-expression group ( P = 0.0041 ). Similar result was found in the training set ( P = 0.0340 ) and verified in the validation set ( P = 0.0292 ). In multivariate Cox regression analysis, FAM225B was identified to be an independent prognostic factor for rGBMs ( P = 0.003 ). Biological process and KEGG pathway analyses implied FAM225B mainly played a functional role on transcription, regulation of transcription, cell migration, focal adhesion, etc. Conclusions. FAM225B is expected to be as a new prognostic biomarker for the identification of rGBM patients with poor outcome. And our study provided a potential therapeutic target for rGBMs.

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Immune-Related LncRNAs as Predictors of Survival in Breast Cancer: A Prognostic Signature

10.21203/rs.3.rs-31519/v1 ◽

2020 ◽

Author(s):

wei ma ◽

fangkun zhao ◽

xinmiao yu ◽

shu guan ◽

huandan suo ◽

...

Keyword(s):

Breast Cancer ◽

Regression Analysis ◽

Cox Regression ◽

Risk Group ◽

Curve Analysis ◽

Time Dependent ◽

Training Set ◽

Roc Curve Analysis ◽

Cox Regression Analysis ◽

Validation Set

Abstract Background: Breast cancer is a highly heterogeneous disease, this poses challenges for classification and management. Long non-coding RNAs play acrucial role in the breast cancers development and progression, especially in tumor-related immune processes which have become the most rapidly investigated area. Methods: We obtained breast cancer patient samples and corresponding clinical data from The Cancer Genome Atlas (TCGA) database. Immune-related lncRNAs were screened by co-expression analysis of immune-related genes which were downloaded from the Immunology Database and Analysis Portal (ImmPort). Clinical patient samples were randomly separatedinto training and testing sets. In the training set, univariate Cox regression analysis and LASSO regression were utilized to build a prognostic immune-related lncRNA signature. The signature was validated in the training set, testing set, and whole cohorts by the Kaplan–Meier log-rank test, time-dependent ROC curve analysis, principal component analysis, univariate and multivariate Cox regression analyses. Results: A total of 937 immune- related lncRNAs were identified, 15 candidate immune-related lncRNAs were significantly associated with overall survival (OS). Eight of these lncRNAs (OTUD6B-AS1, AL122010.1, AC136475.2, AL161646.1, AC245297.3, LINC00578, LINC01871, AP000442.2) were selected for establishment of the risk prediction model. The OS of patients in the low-risk group was higher than that of patients in the high-risk group( p= 1.215e−06 in the training set; p =0.0069 in the validation set; p =1.233e−07 in whole cohort). The time-dependent ROC curve analysis revealed that the AUCs for OS in the first, eighth, and tenth year were 0.812, 0.81, and 0.857, respectively, in the training set, 0.615, 0.68, 0.655 in the validation set, and 0.725, 0.742, 0.741 in the total cohort. Multivariate Cox regression analysis indicated the model was a reliable and independent indicator for the prognosis of breast cancer in the training set (HR= 1.432; 95% CI 1.204−1.702, p <0.001), validation set (HR= 1.162; 95% CI 1.004−1.345, p = 0.044), and whole set (HR=1.240; 95% CI 1.128−1.362, p <0.001). GSEA analysis revealed a strong connection between the signature and immune-related biological processes and pathways. Conclusions: We constructed and verified a robust signature of 8 immune-related lncRNAs for the prediction of breast cancer patient survival.

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Immune-related lncRNAs as predictors of survival in breast cancer: a prognostic signature

10.21203/rs.3.rs-31519/v2 ◽

2020 ◽

Author(s):

wei ma ◽

fangkun zhao ◽

xinmiao yu ◽

shu guan ◽

huandan suo ◽

...

Keyword(s):

Breast Cancer ◽

Regression Analysis ◽

Cox Regression ◽

Risk Group ◽

Curve Analysis ◽

Time Dependent ◽

Training Set ◽

Roc Curve Analysis ◽

Cox Regression Analysis ◽

Validation Set

Abstract Background: Breast cancer is a highly heterogeneous disease, this poses challenges for classification and management. Long non-coding RNAs play acrucial role in the breast cancersdevelopment and progression, especially in tumor-related immune processes which have become the most rapidly investigated area. Therefore, we aimed at developing an immune-related lncRNA signature to improve the prognosis prediction of breast cancer.Methods: We obtained breast cancer patient samples and corresponding clinical data from The Cancer Genome Atlas (TCGA) database. Immune-related lncRNAs were screened by co-expression analysis of immune-related genes which were downloaded from the Immunology Database and Analysis Portal (ImmPort). Clinical patient samples were randomly separated into training and testing sets. In the training set, univariate Cox regression analysis and LASSO regression were utilized to build a prognostic immune-related lncRNA signature. The signature was validated in the training set, testing set, and whole cohorts by the Kaplan–Meier log-rank test, time-dependent ROC curve analysis, principal component analysis, univariate andmultivariate Cox regression analyses.Results:A total of 937 immune- related lncRNAs were identified, 15 candidate immune-related lncRNAs were significantly associated with overall survival (OS). Eight of these lncRNAs (OTUD6B-AS1, AL122010.1, AC136475.2, AL161646.1, AC245297.3, LINC00578, LINC01871, AP000442.2) were selected for establishment of the risk prediction model. The OS of patients in the low-risk group was higher than that of patients in the high-risk group(p=1.215e−06 in the training set; p=0.0069 in the validation set; p=1.233e−07 in whole cohort). The time-dependent ROC curve analysis revealed that the AUCs for OS in the first, eighth, and tenth year were 0.812, 0.81, and 0.857, respectively, in the training set,0.615, 0.68, 0.655 in the validation set, and 0.725, 0.742, 0.741 in the total cohort. Multivariate Cox regression analysis indicated the model was a reliable and independent indicator for the prognosis of breast cancer in the training set (HR= 1.432; 95% CI 1.204−1.702, p<0.001), validation set (HR= 1.162; 95% CI 1.004−1.345, p = 0.044), and whole set (HR=1.240; 95% CI 1.128−1.362, p<0.001). GSEA analysis revealed a strong connection between the signature and immune-related biological processes and pathways.Conclusions:We constructed and verified a robust signature of 8 immune-related lncRNAs for the prediction of breast cancer patient survival.

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A Five-Immune-Related lncRNA Signature Predicts Survival of Patients With Osteosarcoma

10.21203/rs.3.rs-800834/v1 ◽

2021 ◽

Author(s):

Jie Huang ◽

Hongyi Lai ◽

Wentao Qin ◽

Zhandong Bo ◽

Zhen Tan ◽

...

Keyword(s):

Regression Analysis ◽

Cox Regression ◽

Enrichment Analysis ◽

Gene Set Enrichment Analysis ◽

Functional Enrichment ◽

Data Matrix ◽

Lasso Regression ◽

Training Set ◽

Cox Regression Analysis ◽

Validation Set

Abstract Background: Osteosarcoma (OS) is the most common primary solid malignant bone tumor, and its metastasis is a prominent cause of high mortality in patients.Methods: A risk signature was constructed based on re-annotating the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) data matrix, of the lncRNAs related to OS prognosis and immunity. From the OS transcription data, which is downloaded from the TARGET, the 1126 lncRNAs those harbour co-expressions with immunity genes were selected by Pearson correlation test and later divided into the training set (n=44) and validation set (n=41) with the caret package of R. With the training set we build the model related to Osteosarcoma prognosis by the univariate and multivariate Cox, and the Lasso regression analysis, and in combination with the clinical factors we conducted the multivariate Cox regression analysis to build the 1-year, 3-year and 5-year survival rate nomograms. Afterwards, we validated the ROC and the calibration curve of the subjects with the validation set and the whole dataset. Lastly, we performed functional enrichment analysis with the GSEA, GO and KEGG to figure out the biological functions of the prognosis genes.Results: The training set was performed in univariate and multivariate Cox regression analysis, identifying 25 lncRNAs correlated with prognosis. Eleven lncRNAs were selected by the least absolute shrinkage and selection operator (LASSO) regression for multivariate cox analysis and Kaplan-Meier (KM) survival analysis. Finally, lncRNAs (RP11-69E11.4, SNHG6, MIR210HG, RP11-750H9.5 and CTD-2341M24.1) risk signature was constructed, and the validation set and the whole dataset were used to evaluate the prediction stability and accuracy of the signature. The survival times of high- and low-risk groups were significantly different in the training set, validation set and the whole dataset. Further, function enrichment and gene set enrichment analysis revealed that the lncRNAs in the signature may affect the proliferation, migration, chemotaxis and combination of Osteosarcoma-related immune cells, and involve in every pathways of OS metabolism. Conclusion: The five lncRNAs survival risk signature could potentially predict the prognosis of OS patients, additionally, may provide novel insights for future clinical diagnosis and treatment of OS.

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A prognostic model based on immune-related long noncoding RNAs for patients with epithelial ovarian cancer

Journal of Ovarian Research ◽

10.1186/s13048-021-00930-w ◽

2022 ◽

Vol 15 (1) ◽

Author(s):

Yao Peng ◽

Hui Wang ◽

Qi Huang ◽

Jingjing Wu ◽

Mingjun Zhang

Keyword(s):

High Risk ◽

Immune Cell ◽

Cox Regression ◽

Risk Group ◽

Principal Component ◽

Risk Groups ◽

Low Risk ◽

Training Set ◽

Cox Regression Analysis ◽

Validation Set

Abstract Background Long noncoding RNAs (lncRNAs) are important regulators of gene expression and can affect a variety of physiological processes. Recent studies have shown that immune-related lncRNAs play an important role in the tumour immune microenvironment and may have potential application value in the treatment and prognosis prediction of tumour patients. Epithelial ovarian cancer (EOC) is characterized by a high incidence and poor prognosis. However, there are few studies on immune-related lncRNAs in EOC. In this study, we focused on immune-related lncRNAs associated with survival in EOC. Methods We downloaded mRNA data for EOC patients from The Cancer Genome Atlas (TCGA) database and mRNA data for normal ovarian tissue from the Genotype-Tissue Expression (GTEx) database and identified differentially expressed genes through differential expression analysis. Immune-related lncRNAs were obtained through intersection and coexpression analysis of differential genes and immune-related genes from the Immunology Database and Analysis Portal (ImmPort). Samples in the TCGA EOC cohort were randomly divided into a training set, validation set and combination set. In the training set, Cox regression analysis and LASSO regression were performed to construct an immune-related lncRNA signature. Kaplan–Meier survival analysis, time-dependent ROC curve analysis, Cox regression analysis and principal component analysis were performed for verification in the training set, validation set and combination set. Further studies of pathways and immune cell infiltration were conducted through Gene Set Enrichment Analysis (GSEA) and the Timer data portal. Results An immune-related lncRNA signature was identified in EOC, which was composed of six immune-related lncRNAs (KRT7-AS, USP30-AS1, AC011445.1, AP005205.2, DNM3OS and AC027348.1). The signature was used to divide patients into high-risk and low-risk groups. The overall survival of the high-risk group was lower than that of the low-risk group and was verified to be robust in both the validation set and the combination set. The signature was confirmed to be an independent prognostic biomarker. Principal component analysis showed the different distribution patterns of high-risk and low-risk groups. This signature may be related to immune cell infiltration (mainly macrophages) and differential expression of immune checkpoint-related molecules (PD-1, PDL1, etc.). Conclusions We identified and established a prognostic signature of immune-related lncRNAs in EOC, which will be of great value in predicting the prognosis of clinical patients and may provide a new perspective for immunological research and individualized treatment in EOC.

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A Prognostic Model Based on Immune-Related Long Non-Coding RNAs for Patients With Epithelial Ovarian Cancer

10.21203/rs.3.rs-752966/v1 ◽

2021 ◽

Author(s):

Yao Peng ◽

Hui Wang ◽

Qi Huang ◽

Jingjing Wu ◽

Mingjun Zhang

Keyword(s):

High Risk ◽

Immune Cell ◽

Cox Regression ◽

Principal Component ◽

Risk Groups ◽

Low Risk ◽

Training Set ◽

Cox Regression Analysis ◽

Validation Set ◽

Differential Genes

Abstract Background: Long non-coding RNA (lncRNA), as an important regulator of gene expression, can affect a variety of physiological processes. Recent studies have shown that immune-related lncRNA play an important role in the tumor immune microenvironment and may have potential application value in the treatment and prognosis prediction of tumor patients. Epithelial ovarian cancer (EOC) is characterized by high incidence and poor prognosis. However, there are few studies on immune-related lncRNAs in EOC. In this study, we focused on the immune-related lncRNAs associated with survival in EOC. Methods: We downloaded mRNA data for EOC patients from The Cancer Genome Atlas (TCGA) database, and mRNA data for normal ovarian tissue from the Genotype-Tissue Expression (GTEx) database, and identified differential genes through differential Expression analysis. Immune-related lncRNAs were obtained through taking intersection and co-expression analysis of differential genes and immune-related genes from the Immunology Database and Analysis Portal (ImmPort). Samples in the TCGA EOC cohort were randomly divided into training set, validation set and combination set. In the training set, Cox regression analysis and LASSO regression were used to construct an immune-related lncRNA signature. Kaplan-Meier survival analysis, time-dependent ROC curve analysis, Cox regression analysis and principal component analysis were applied to verification in the training set, training set, validation set and combination set. Further studies of pathways and immune cell infiltration were conducted through Gene Set Enrichment Analysis (GESA) and the Timer data portal.Results: An immune-related lncRNA signature was identified in EOC, which was composed of six immune-related lncRNAs (KRT7-AS, USP30-AS1, AC011445.1, AP005205.2, DNM3OS and AC027348.1). The signature divided patients into high-risk and low-risk groups. The overall survival of the high-risk group was lower than that of the low-risk group, and was verified to be robust in both the training set and the combination set. This signature was identified as an independent prognostic biomarker. The signature was confirmed to be an independent prognostic biomarker. Principal component analysis showed the different distribution patterns of high-risk and low-risk groups. This signature may be related to immune cell infiltration (mainly macrophages) and differential expression of immune checkpoint-related molecules (PD-1, PDL1, etc.). Conclusions: we identified and established a prognostic signature of immune-related lncRNA in EOC, which is of great value in predicting the prognosis of clinical patients and may provide a new perspective for the immunological research and individualized treatment in EOC.

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A Prognostic Model for Patients With Gastric Signet Ring Cell Carcinoma

Technology in Cancer Research & Treatment ◽

10.1177/15330338211027912 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110279

Author(s):

Qinping Guo ◽

Yinquan Wang ◽

Jie An ◽

Siben Wang ◽

Xiushan Dong ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Cox Regression ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Training Set ◽

Cox Regression Analysis ◽

Signet Ring ◽

Ring Cell ◽

Independent Risk Factors

Background: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). Methods: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. Results: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. Conclusion: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.

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Natural history definition and a suggested clinical approach to Buerger's disease: a case-control study with survival analysis

Vascular ◽

10.1258/vasc.2011.oa0323 ◽

2012 ◽

Vol 20 (4) ◽

pp. 198-202 ◽

Cited By ~ 6

Author(s):

Bahare Fazeli ◽

Hassan Ravari ◽

Reza Assadi

Keyword(s):

Multivariate Analysis ◽

Natural History ◽

Cox Regression ◽

Major Amputation ◽

Clinical Approach ◽

Buerger’S Disease ◽

Buerger's Disease ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

History Of

The aim of this study was first to describe the natural history of Buerger's disease (BD) and then to discuss a clinical approach to this disease based on multivariate analysis. One hundred eight patients who corresponded with Shionoya's criteria were selected from 2000 to 2007 for this study. Major amputation was considered the ultimate adverse event. Survival analyses were performed by Kaplan–Meier curves. Independent variables including gender, duration of smoking, number of cigarettes smoked per day, minor amputation events and type of treatments, were determined by multivariate Cox regression analysis. The recorded data demonstrated that BD may present in four forms, including relapsing-remitting (75%), secondary progressive (4.6%), primary progressive (14.2%) and benign BD (6.2%). Most of the amputations occurred due to relapses within the six years after diagnosis of BD. In multivariate analysis, duration of smoking of more than 20 years had a significant relationship with further major amputation among patients with BD. Smoking cessation programs with experienced psychotherapists are strongly recommended for those areas in which Buerger's disease is common. Patients who have smoked for more than 20 years should be encouraged to quit smoking, but should also be recommended for more advanced treatment for limb salvage.

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