Additional value of MRI-detected EMVI scoring system in rectal cancer: applicability in predicting synchronous metastasis

2020 ◽  
Vol 106 (4) ◽  
pp. 286-294 ◽  
Author(s):  
Pratik Tripathi ◽  
Weifeng Guo ◽  
Shengxiang Rao ◽  
Mengsu Zeng ◽  
Daoyu Hu
Keyword(s):  
Rectal Cancer ◽  
Risk Factor ◽  
Survival Rate ◽  
Distant Metastasis ◽  
Odds Ratio ◽  
Scoring System ◽  
Lymphatic Invasion ◽  
Synchronous Metastasis ◽  
Potential Biomarker ◽  
T3 Rectal Cancer

Introduction: Extramural vascular invasion (EMVI) has been recommended as an independent prognostic factor for poor overall survival rate in rectal cancer and can be used as a potential biomarker. Early prediction of prevalence of synchronous metastasis can elevate the disease-free survival rate. We aimed to evaluate the magnetic resonance imaging (MRI)–detected EMVI (mrEMVI) scoring system in predicting distant metastasis in T3 rectal cancer. Methods: Patients with postoperative histopathologically confirmed T3 rectal cancer without previous treatment from July 2014 to December 2015 were enrolled in this study. Two blinded radiologists evaluated mrEMVI status. mrEMVI was categorized as EMVI-positive or EMVI-negative in T2-weighted images using an mrEMVI scoring system. The results, along with other clinical characteristics (age, sex, tumor location, MRI-detected distance of mesorectal extension, lymphatic invasion, perineural invasion, mrEMVI score, and carcinoembryonic antigen [CEA]), were then correlated with synchronous metastases to determine the risk factors using univariate and multivariate analysis. Results: Of 180 patients, 38 were confirmed to be mrEMVI-positive, 142 mrEMVI-negative. There were 34 patients with synchronous metastasis, of whom 25 were mrEMVI-positive and 9 were mrEMVI-negative. Three factors were significantly associated with synchronous metastasis: mrEMVI ( p = 0.001; odds ratio = 8.665), histopathologic lymphatic invasion ( p = 0.001; odds ratio = 12.940), and preoperative CEA ( p = 0.026; odds ratio = 4.124). mrEMVI score 4 was more likely for synchronous metastasis ( p = 0.044; odds ratio = 9.429) than mrEMVI score 3 in rectal cancer. Conclusions: mrEMVI positivity is an independent risk factor for synchronous distant metastasis in rectal cancer. mrEMVI score 4 is a stronger risk factor for synchronous metastasis than mrEMVI score 3 in rectal cancer.

Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI

2015 ◽  
Vol 26 (2) ◽  
pp. 297-305 ◽  
Author(s):  
Young Chul Kim ◽  
Jai Keun Kim ◽  
Myeong-Jin Kim ◽  
Jei Hee Lee ◽  
Young Bae Kim ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Distant Metastasis ◽  
Vascular Invasion ◽  
T3 Rectal Cancer ◽  
Early Distant Metastasis

Assessment of gastric cancer malignancy based on CD133 and thrombospondin1 (THBS1) expression and the role of histone acetylation.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 31-31
Author(s):  
Hirohiko Sato ◽  
Mitsuo Shimada ◽  
Nobuhiro Kurita ◽  
Takashi Iwata ◽  
Masanori Nishioka ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Distant Metastasis ◽  
Poor Prognosis ◽  
Epigenetic Modification ◽  
Hypoxia Inducible Factor ◽  
Lymphatic Invasion ◽  
The Other ◽  
Peritoneal Cytology ◽  
Degree Of Malignancy

31 Background: Epigenetic modification by HDAC (histone deacetylase) plays important roles in the development and progression of cancer. It has been reported that CD133 positive cancer stem cells were induced through the HDAC → HIF-1α (Hypoxia Inducible Factor-1α) pathway, and Thrombospondin1 (THBS1) is associated with tumor angiogenesis. The aim of this study is to evaluate relationship between the HDAC, CD133, THBS1 and prognosis in gastric cancer. Methods: 65 patients of gastric cancer were enrolled in this study. HDAC1, CD133 and THBS1 expressions were evaluated in immunohistochemical (IHC) staining of surgical specimens. Relationship between the expressions of HDAC1, CD133, THBS1 and clinicopathological factors was investigated. Results: HDAC1-positive patients were 52% and had significantly poor prognosis compared with negative patients. There were more frequent liver metastasis and lymphatic invasion in positive patients. CD133-positive patients were 23.1% and had significantly poor prognosis compared with negative patients. There were more frequent depth wall invasion, distant metastasis, peritoneal recurrence. THBS1-positive patients were 26% and had significantly better prognosis compared with negative patients. In THBS1 positive patients, there was less lymph node metastasis, positive peritoneal cytology in ascites, distant metastasis and lymphatic invasion. CD133 expression is positively correlated with HDAC1. THBS1 expression revealed negative correlation with HDAC1. The survival rate of HDAC1 (+) / CD133 (+) group was significantly poor prognosis compared to the other group (HDAC1 (+) / CD133 (-), HDAC1 (-) / CD133 (+), HDAC1 (-) / CD133 (-)). HDAC1 (-) / THBS1 (+) group revealed significantly higher survival rate compared to the other group (HDAC1 (-) / THBS1 (+), HDAC1 (+) / THBS1 (+), HDAC1 (+) / THBS1 (-)). Conclusions: It was suggested that HDAC1 promoted CD133, suppressed THBS1 in gastric cancer and their interaction were increased the degree of malignancy.

scholarly journals Uncorrected cardiac malformation is the major risk factor for death in patients with dextrocardia

2021 ◽  
Author(s):  
Xiaofeng Lu ◽  
Wenzhu Dang ◽  
Shenglin Li ◽  
Xu Wang ◽  
Bingren Gao ◽  
...  
Keyword(s):  
Information System ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Survival Rate ◽  
Situs Inversus ◽  
Odds Ratio ◽  
Congenital Heart ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cardiac Malformation

AbstractBackground/ObjectivesDextrocardia is rare in the general population. We aimed to analyze the clinical characteristics and risk factors for survival rate of dextrocardia patients during 2013 to 2018 in our hospital, through a specialized Hospital Information System.MethodsA retrospective study of patients with dextrocardia was performed through Hospital Information System. International Classification of Diseases 10 was searched to identify eligible cases from January 2013 to December 2018 in our hospital. Medical records were reviewed to acquire the basic information of dextrocardia patients.ResultsAmong 9304 patients diagnosed with congenital heart disease in past six years, 48 (0.51%) had dextrocardia. Among 48 dextrocardia patients, 28 (58.33%) had situs inversus viscerum, 20 (41.67%) had cardiac malformation, nine (18.75%) had other malformations and 16 (33.33%) had no malformation. Compared with patients with uncorrected cardiac malformation, patients without cardiac malformation were older (43.5000 vs 0.4583 years, P<0.001). The dextrocardia patients’ age of onset correlated significantly with cardiac malformation. Multivariable logistic model showed the significant risk factor for survival rate was uncorrected cardiac malformation (odds ratio, 22.2391; P <0.001). However, situs inversus (odds ratio, 1.9750; P= 0.4399) or pneumonia (odds ratio, 4.2610; P= 0.0849) itself was not a significant risk factor for survival rate. Kaplan–Meier plot shown that dextrocardia patients with uncorrected cardiac malformation had lower survival rate than those without cardiac malformation (P<0.0001), and there is no significant difference between healthy cohort and patients with pure dextrocardia with or without situs inversus (P=0.25).ConclusionsDextrocardia remains a rare finding in population, even in the group of patients with known congenital heart disease. Dextrocardia was associated with various malformations besides cardiac malformation. Uncorrected cardiac malformation, which should be paid high attention in the developing countries, is the main risk factor for death in patients with dextrocardia, and pure dextrocardia with or without situs inversus has no effect on survival rate of dextrocardia patients.

The 20210 A Allele of the Prothrombin Gene Is a Common Risk Factor among Swedish Outpatients with Verified Deep Venous Thrombosis

1997 ◽  
Vol 78 (03) ◽  
pp. 0990-0992 ◽  
Author(s):  
Andreas Hillarp ◽  
Bengt Zӧller ◽  
Peter J Svensson ◽  
Bjӧrn Dahlbäck
Keyword(s):  
Risk Factor ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Odds Ratio ◽  
Untranslated Region ◽  
Control Group ◽  
Common Risk Factor ◽  
Apc Resistance ◽  
Healthy Control ◽  
Prothrombin Gene

SummaryA dimorphism in the 3’-untranslated region of the prothrombin gene (G to A transition at position 20210) has recently been reported to be associated with increases in plasma prothrombin levels and in the risk of venous thrombosis (1). We have examined the prothrombin dimorphism among 99 unselected outpatients with phlebography verified deep venous thrombosis, and in 282 healthy controls. The prevalence of the 20210 A allele was 7.1% (7/99) in the patient group, and 1.8% (5/282) in the healthy control group (p = 0.0095). The relative risk of venous thrombosis was calculated to be 4.2 (95% Cl, 1.3 to 13.6), and was still significant when adjustment was made for age, sex and the factor V:R506Q mutation causing APC resistance [odds ratio 3.8 (95% Cl, 1.1 13.2)]. As previously reported, 28% of the patients were carriers of the factor V:R506Q mutation. Thus, 34% (one patient carried both traits) of unselected patients with deep venous thrombosis were carriers of an inherited prothrombotic disorder. To sum up, our results confirm the 20210 A allele of the prothrombin gene to be an important risk factor for venous thrombosis.

scholarly journals The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
I-Li Lai ◽  
Jeng-Fu You ◽  
Yih-Jong Chern ◽  
Wen-Sy Tsai ◽  
Jy-Ming Chiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Local Recurrence ◽  
Distant Metastasis ◽  
Resection Margin ◽  
Radical Resection ◽  
Hazard Ratio ◽  
Low Rectal Cancer ◽  
Distal Resection Margin ◽  
Lymph Node Yield

Abstract Background Radical resection is associated with good prognosis among patients with cT1/T2Nx rectal cancer. However, still some of the patients experienced cancer recurrence following radical resection. This study tried to identify the postoperative risk factors of local recurrence and distant metastasis separately. Methods This retrospective, single-center study comprised of 279 consecutive patients from Linkou branch of Chang Gung Memorial Hospital in 2005–2016 with rectal adenocarcinoma, pT1/T2N0M0 at distance from anal verge ≤ 8cm, who received curative radical resection. Results The study included 279 patients with pT1/pT2N0 mid-low rectal cancer with median follow-up of 73.5 months. Nineteen (6.8%) patients had disease recurrence in total. Nine (3.2%) of them had local recurrence, and fourteen (5.0%) of them had distant metastasis. Distal resection margin < 0.9 (cm) (hazard ratio = 4.9, p = 0.050) was the risk factor of local recurrence. Preoperative carcinoembryonic antigen (CEA) ≥ 5 ng/mL (hazard ratio = 9.3, p = 0.0003), lymph node yield (LNY) < 14 (hazard ratio = 5.0, p = 0.006), and distal resection margin < 1.4cm (hazard ratio = 4.0, p = 0.035) were the risk factors of distant metastasis. Conclusion For patients with pT1/pT2N0 mid-low rectal cancer, current multidisciplinary treatment brings acceptable survival outcome. Insufficient distal resection margin attracted the awareness of risk factors for local recurrence and distant metastasis as a foundation for future research.

scholarly journals Eosinophil-to-monocyte ratio is a potential biomarker in the prediction of functional outcome among patients with acute ischemic stroke

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuhong Yu ◽  
Yi Luo ◽  
Tan Zhang ◽  
Chenrong Huang ◽  
Yu Fu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Odds Ratio ◽  
Poor Outcome ◽  
Net Reclassification Improvement ◽  
Potential Biomarker ◽  
The Impact ◽  
The Relationship ◽  
Integrated Discrimination Improvement

Abstract Background It has been shown that eosinophils are decreased and monocytes are elevated in patients with acute ischemic stroke (AIS), but the impact of eosinophil-to-monocyte ratio (EMR) on clinical outcomes among AIS patients remains unclear. We aimed to determine the relationship between EMR on admission and 3-month poor functional outcome in AIS patients. Methods A total of 521 consecutive patients admitted to our hospital within 24 h after onset of AIS were prospectively enrolled and categorized in terms of quartiles of EMR on admission between August 2016 and September 2018. The endpoint was the poor outcome defined as modified Rankin Scale score of 3 to 6 at month 3 after admission. Results As EMR decreased, the risk of poor outcome increased (p < 0.001). Logistic regression analysis revealed that EMR was independently associated with poor outcome after adjusting potential confounders (odds ratio, 0.09; 95% CI 0.03–0.34; p = 0.0003), which is consistent with the result of EMR (quartile) as a categorical variable (odds ratio, 0.23; 95% CI 0.10–0.52; ptrend < 0.0001). A non-linear relationship was detected between EMR and poor outcome, whose point was 0.28. Subgroup analyses further confirmed these associations. The addition of EMR to conventional risk factors improved the predictive power for poor outcome (net reclassification improvement: 2.61%, p = 0.382; integrated discrimination improvement: 2.41%, p < 0.001). Conclusions EMR on admission was independently correlated with poor outcome in AIS patients, suggesting that EMR may be a potential prognostic biomarker for AIS.

scholarly journals Clinicopathological significance of primitive phenotypes in early gastric cancer with differentiated histology

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhi-Yi Zhou ◽  
Jie Sun ◽  
Qing Guo ◽  
Hai-Bin Zhao ◽  
Zhi-Hua Zhou
Keyword(s):  
Gastric Cancer ◽  
Risk Factor ◽  
Early Gastric Cancer ◽  
Endoscopic Resection ◽  
Independent Risk Factor ◽  
Lymphatic Invasion ◽  
Clinicopathological Features ◽  
Surgical Operation ◽  
Tissue Sections ◽  
Clinicopathological Significance

Abstract Background Certain gastric cancers exhibit some primitive phenotypes, which may indicate a high malignancy. In histologically differentiated early gastric cancer (EGC), the presence and the clinicopathological significance of the primitive phenotype remain unclear. Methods Using immunohistochemical staining we detected the expression of three primitive phenotypic markers SALL4, Glypican-3(GPC3), and AFP in whole tissue sections of differentiated EGC (gastrectomy specimens, n = 302). For those cases with primitive phenotypes, we analyzed their clinicopathological features and evaluated whether the criteria for endoscopic resection were met. Results We found that 9.3% (28/302) of all differentiated EGC cases have primitive phenotypes, and most of these cases (25/28) exhibit a histomorphology similar to conventional differentiated EGC. Patients with primitive phenotypes had a deeper invasion, a higher rate of ulcer and lymphatic invasion than cases without primitive phenotype. Moreover, patients with primitive phenotypes displayed a significantly higher frequency of LNM than those without (57.1% vs 8.8%, P < 0.001). Multivariate analysis revealed that presence of primitive phenotypes was an independent risk factor for LNM (P = 0.001, HR 6.977, 95% CI: 2.199–22.138). Interestingly, we found 2 cases with primitive phenotypes developed LNM, and they both met the expanded indications of endoscopic resection for differentiated EGC. Conclusions A small number of differentiated EGC have primitive phenotypes, which were closely related to LNM and were an independent risk factor for LNM. Given its highly aggressive behavior, differentiated EGC with primitive phenotypes should be evaluated with stricter criteria before endoscopic resection, or considered to give an additional surgical operation after endoscopic resection.

Components of a risk assessment tool for prevention and control of bovine respiratory disease in preweaned dairy calves

2020 ◽  
pp. 1-7
Author(s):  
Sharif S. Aly ◽  
Betsy M. Karle ◽  
Deniece R. Williams ◽  
Gabriele U. Maier ◽  
Sasha Dubrovsky
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Risk Factor ◽  
Respiratory Disease ◽  
Scoring System ◽  
Prevention And Control ◽  
Assessment Tool ◽  
Bovine Respiratory Disease ◽  
And Control ◽  
Management Changes

Abstract Bovine respiratory disease (BRD) is the leading natural cause of death in US beef and dairy cattle, causing the annual loss of more than 1 million animals and financial losses in excess of $700 million. The multiple etiologies of BRD and its complex web of risk factors necessitate a herd-specific intervention plan for its prevention and control on dairies. Hence, a risk assessment is an important tool that producers and veterinarians can utilize for a comprehensive assessment of the management and host factors that predispose calves to BRD. The current study identifies the steps taken to develop the first BRD risk assessment tool and its components, namely the BRD risk factor questionnaire, the BRD scoring system, and a herd-specific BRD control and prevention plan. The risk factor questionnaire was designed to inquire on aspects of calf-rearing including management practices that affect calf health generally, and BRD specifically. The risk scores associated with each risk factor investigated in the questionnaire were estimated based on data from two observational studies. Producers can also estimate the prevalence of BRD in their calf herds using a smart phone or tablet application that facilitates selection of a true random sample of calves for scoring using the California BRD scoring system. Based on the risk factors identified, producers and herd veterinarians can then decide the management changes needed to mitigate the calf herd's risk for BRD. A follow-up risk assessment after a duration of time sufficient for exposure of a new cohort of calves to the management changes introduced in response to the risk assessment is recommended to monitor the prevalence of BRD.

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