Estrogen Receptor Classification for Hepatocellular Carcinoma: Comparison With Clinical Staging Systems

2003 ◽  
Vol 21 (3) ◽  
pp. 441-446 ◽  
Author(s):  
Erica Villa ◽  
Alessandra Colantoni ◽  
Calogero Cammà ◽  
Antonella Grottola ◽  
Paola Buttafoco ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Estrogen Receptor ◽  
Multivariate Analysis ◽  
Classification System ◽  
Scoring System ◽  
Scoring Systems ◽  
Classification Systems ◽  
Clinical Staging ◽  
Therapeutic Decisions ◽  
Staging Systems

Purpose: Several scoring systems to evaluate patients with hepatocellular carcinoma (HCC) exist. A good scoring system should provide information on prognosis and guide therapeutic decisions. The presence of variant liver estrogen receptor (ER) transcripts in the tumor has been shown to be the strongest negative predictor of survival in HCC. The aim of this study was to compare the predictive value of the commonly applied clinical scoring systems for survival of patients with HCC with that of the evaluation of ER in patients with HCC (molecular scoring system). Materials and Methods: HCC was staged according to the Okuda classification, Barcelona Clinic Liver Cancer classification, Italian classification system (CLIP), French classification, and ER status in 96 patients. Analysis of survival was performed according to the Kaplan-Maier test and was made for each classification system and ER. A comparison between classifications was made by univariate and multivariate analysis. Results: Among the clinical classification systems, only the CLIP was able to identify patient populations with good, intermediate, and poor prognosis. On multivariate analysis, ER classification was shown to be the best predictive classification for survival of patients with HCC (P <.0001). This difference was the result of a better allocation of patients with ominous prognosis (variant ER) having nevertheless good clinical score. Conclusion: The evaluation of the presence of wild-type or variant ER transcripts in the tumor is the best predictor of survival in patients with HCC. Its accuracy in discriminating patients with good or unfavorable prognosis is significantly greater than that of the commonly used scoring systems for the staging of HCC.

Clinical staging systems for hepatocellular carcinoma: Comparison with estrogen receptor classification

2003 ◽  
Vol 38 ◽  
pp. 106-107
Author(s):  
E. Villa ◽  
A. Colantoni ◽  
C. Camma ◽  
A. Grottola ◽  
I. Ferretti ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Estrogen Receptor ◽  
Clinical Staging ◽  
Staging Systems

Exploring prognostic indicators in the pathological images of hepatocellular carcinoma based on deep learning

Gut ◽  
2020 ◽  
pp. gutjnl-2020-320930 ◽  
Author(s):  
Jie-Yi Shi ◽  
Xiaodong Wang ◽  
Guang-Yu Ding ◽  
Zhou Dong ◽  
Jing Han ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Deep Learning ◽  
Genetic Alterations ◽  
The Cancer Genome Atlas ◽  
Clinical Staging ◽  
Patient Treatment ◽  
Prognostic Indicators ◽  
Omics Data ◽  
Learning Framework ◽  
Staging Systems

ObjectiveTumour pathology contains rich information, including tissue structure and cell morphology, that reflects disease progression and patient survival. However, phenotypic information is subtle and complex, making the discovery of prognostic indicators from pathological images challenging.DesignAn interpretable, weakly supervised deep learning framework incorporating prior knowledge was proposed to analyse hepatocellular carcinoma (HCC) and explore new prognostic phenotypes on pathological whole-slide images (WSIs) from the Zhongshan cohort of 1125 HCC patients (2451 WSIs) and TCGA cohort of 320 HCC patients (320 WSIs). A ‘tumour risk score (TRS)’ was established to evaluate patient outcomes, and then risk activation mapping (RAM) was applied to visualise the pathological phenotypes of TRS. The multi-omics data of The Cancer Genome Atlas(TCGA) HCC were used to assess the potential pathogenesis underlying TRS.ResultsSurvival analysis revealed that TRS was an independent prognosticator in both the Zhongshan cohort (p<0.0001) and TCGA cohort (p=0.0003). The predictive ability of TRS was superior to and independent of clinical staging systems, and TRS could evenly stratify patients into up to five groups with significantly different prognoses. Notably, sinusoidal capillarisation, prominent nucleoli and karyotheca, the nucleus/cytoplasm ratio and infiltrating inflammatory cells were identified as the main underlying features of TRS. The multi-omics data of TCGA HCC hint at the relevance of TRS to tumour immune infiltration and genetic alterations such as the FAT3 and RYR2 mutations.ConclusionOur deep learning framework is an effective and labour-saving method for decoding pathological images, providing a valuable means for HCC risk stratification and precise patient treatment.

scholarly journals Currently available classification systems for lower cervical spine injuries. Part 1. Overview of the most popular scales and classifications

2019 ◽  
Vol 21 (1) ◽  
pp. 90-102 ◽  
Author(s):  
A. A. Grin ◽  
I. S. Lvov ◽  
S. L. Arakelyan ◽  
A. E. Talypov ◽  
A. Yu. Kordonsky ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Injury Severity ◽  
Scoring Systems ◽  
Classification Systems ◽  
Spine Injury ◽  
Lower Cervical Spine ◽  
Cervical Spine Injuries ◽  
Advantages And Disadvantages ◽  
Spine Injuries

This article provides a detailed illustrated description of currently available classification and scoring systems for lower cervical spine injuries (including Allen–Fergusson, J. Harris et al., C. Argenson et al., and AOSpine classifications, Subaxial Injury Classification System and Cervical Spine Injury Severity Score). The present review primarily aims to discuss the advantages and disadvantages of each classification system. 

scholarly journals Hepatoceliulinės karcinomos prognostinės sistemos

2008 ◽  
Vol 6 (3) ◽  
pp. 0-0
Author(s):  
Jonas Pivoriūnas ◽  
Jonas Jurgaitis ◽  
Marius Paškonis ◽  
Agnius Juška ◽  
Janina Didžiapetrienė ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Primary Liver Cancer ◽  
Prognostic Score ◽  
Scoring Systems ◽  
The United States ◽  
University Hospital ◽  
Prognostic Scores ◽  
Key Words Hepatocellular Carcinoma ◽  
Staging Systems ◽  
Vilnius University

Jonas Pivoriūnas1, Jonas Jurgaitis2, 3, Marius Paškonis2, 3, Agnius Juška1, Janina Didžiapetrienė3, Eugenijus Stratilovas3, Narimantas Evaldas Samalavičius3, Vitalijus Sokolovas3, Gintautas Brimas2, Kęstutis Strupas21 Vilniaus universiteto Medicinos fakultetas, M. K. Čiurlionio g. 21, LT-03101 Vilnius2 Gastroenterologijos, urologijos ir abdominalinės chirurgijos klinika,Vilniaus universiteto ligoninės Santariškių klinikos, Santariškių g. 2, LT-08661 Vilnius3 Vilniaus universiteto Onkologijos institutas Santariškių g. 1, LT-08660 VilniusEl paštas: [email protected] Įvadas / tikslas Hepatoceliulinė karcinoma – tai penktas tarp dažniausių navikų pasaulyje ir trečias pagal mirštamumą. Per pastaruosius dešimtmečius sergamumas šiuo naviku didėja Jungtinėse Amerikos Valstijose ir Europoje. Lietuvoje hepatoceliulinės karcinomos atvejų taip pat daugėja. Manoma, kad kepenų navikų per kitus du dešimtmečius dar padaugės. Hepatoceliulinė karcinoma yra sunkiai įvertinama, heterogoniška liga, dėl to pasaulyje kuriamos prognostinės sistemos, kurios turi padėti gydytojui parinkti tinkamą gydymą ir įvertinti ligos prognozę. Šio straipsnio tikslas – išrinkti ir apibūdinti labiausiai pasaulyje paplitusias hepatoceliulinės karcinomos prognostines sistemas, palyginti jų taikymo rezultatus, parinkti Lietuvai tinkamiausias sistemas. Metodai Pasinaudojus „PubMed“ duomenų baze ir įvedus reikšminius žodžius hepatocellular carcinoma, prognostic scores ir staging system buvo rasti 205 straipsniai, publikuoti nuo 1984 iki 2007 metų. Atrinkti 54 straipsniai, kuriuose minimos 24-ios hepatoceliulinės karcinomos prognostinės sistemos. Rezultatai Išanalizavus sistemas buvo nuspręsta atmesti tas, kurių pritaikyti Lietuvoje nėra galimybių dėl to, kad šalyje neatliekami tyrimai. Plačiau aprašytos devynios sistemos. Išvados Išrinkę plačiausiai pasaulyje naudojamas hepatoceliulinės karcinomos prognostines sistemas ir palyginę jų taikymo rezultatus, manome, kad būtų vertinga atlikti retrospektyvųjį lyginamąjį tyrimą, kad išsiaiškintume, kokia prognostinė sistema geriausiai tinka hepatoceliuline karcinoma sergantiems Lietuvos populiacijos pacientams diferencijuoti pagal išgyvenamumą. Reikšminiai žodžiai: hepatoceliulinė karcinoma, prognostinė sistema, prognostiniai kriterijai, pacientų išgyvenamumas Prognostic scores of hepatocellular carcinoma Jonas Pivoriūnas1, Jonas Jurgaitis2, 3, Marius Paškonis2, 3, Agnius Juška1, Janina Didžiapetrienė3, Eugenijus Stratilovas3, Narimantas Evaldas Samalavičius3, Vitalijus Sokolovas3, Gintautas Brimas2, Kęstutis Strupas21 Vilnius University Faculty of Medicine, M. K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania2 Clinic of Gastroenterology, Urology and Abdominal Surgery,Vilnius University Hospital Santariškių Clinic, Santariškių str. 2, LT-08661 Vilnius, Lithuania3 Institute of Oncology, Vilnius University, Santariškių str. 1, LT-08660 Vilnius, LithuaniaE-mail: [email protected] Background / objective Hepatocellular carcinoma is the most common primary liver cancer. It is the fifth most common neoplasm and the third most common cause of cancer-related death in the world. Over the last decade the incidence of this cancer has been rising in the United States of America and in Europe as well as in Lithuania. The incidence of this cancer in the next two decades is expected to rise. Hepatocelullar carcinoma is a difficult and heterogenic disease. Therefore, prognostic scores are being created to help clinicians to choose the best treatment for the patient. The aim of this review is to select and describe the most widely used prognostic systems of hepatocellular carcinoma, to compare results of their usage, applicability and to choose the most suitable scoring systems for the further use in Lithuania. Methods The PubMed data base was used to search for the keywords: “hepatocellular carcinoma”, “prognostic scores” and “staging systems”. 205 published articles were found from the year 1984 though 2007; 54 articles with 24 prognostic systems were selected. Results Upon analysing the prognostic systems, it was decided to reject the scoring systems that are impossible to use in Lithuania because of the absence of related tests. In total, nine prognostic systems were overviewed. Conclusions A retrospective cohort study is advisable to ascertain which prognostic system of hepatocellular carcinoma is most suitable for Lithuanian population. Key words: hepatocellular carcinoma, prognostic score, prognostic factors, survival of the patient

Predictive scoring systems for brain metastasis at diagnosis and at recurrence in non-small cell lung cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19020-e19020
Author(s):  
S. T. Maunglay ◽  
W. J. Fulp ◽  
A. Chiappori ◽  
G. R. Simon
Keyword(s):  
Lung Cancer ◽  
Multivariate Analysis ◽  
Brain Metastasis ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Scoring System ◽  
Scoring Systems ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Recurrence

e19020 Background: Brain metastasis (BM) is a major cause of mortality and morbidity in Non Small Cell Lung Cancer (NSCLC) but large studies analyzing potential factors that could be predictive of BM at diagnosis or recurrence are lacking. We have developed 2 predictive scoring models to identify the patients at risk. Methods: A retrospective analysis on 4,294 NSCLC cases, seen between 1994 and 2006, at the Moffitt Cancer Center and Research Institute, Tampa, FL was performed utilizing the cancer center's registry data. 477 (11.12%) patients had BM at the time diagnosis and additional 252 (5.82%) patients developed new BM as first recurrence. Results: For patients with BM at diagnosis, age younger than 63 years, non squamous histology and current or never smoking status were all significant in both univariate and multivariate analysis (N= 4174). Based on calculated odds ratios, a scoring system of 0 to 6 points was developed for these patients. Higher scores predicted higher risk for BM (0- 2=3.38%, 3- 4=9.93%, 5=13.65% and 6=21.03%; p <.0001). For patients with new BM at first recurrence, age younger than 63 years, non squamous histology, and the stage at diagnosis (i.e., BM risk in stage III>IV>II>I), were all significant in both univariate and multivariate analysis (N=4291). Based on calculated odds ratios, a scoring system of 0 to 7 points was developed for these patients. Higher scores predicted higher risk for BM (0–1=3.38%, 2–3=4.72%, 4–5= 8.76%, and 6–7=11.83%; p<.0001). Similar risk percentage results were seen after testing the 2 scoring systems in 3 chronologically divided patient groups. Conclusions: The 2 scoring systems developed based only on clinical data were predictive of BM in NSCLC at diagnosis and recurrence. These scoring systems should be helpful for establishing initial and follow up cranial imaging schedules in NSCLC patients. [Table: see text] No significant financial relationships to disclose.

scholarly journals Evaluation of Eight Different Clinical Staging Systems Associated with Overall Survival of Chinese Patients with Hepatocellular Carcinoma

2015 ◽  
Vol 128 (3) ◽  
pp. 316-321 ◽  
Author(s):  
Jian-Jun Zhao ◽  
Tao Yan ◽  
Hong Zhao ◽  
Jian-Guo Zhou ◽  
Zhen Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Chinese Patients ◽  
Clinical Staging ◽  
Staging Systems

scholarly journals Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Zafer Dokumcu ◽  
Bade Toker Kurtmen ◽  
Emre Divarci ◽  
Petek Bayindir Tamay ◽  
Timur Kose ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Sensitivity And Specificity ◽  
Scoring System ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Duration Of Symptoms ◽  
Suspected Appendicitis ◽  
Radiological Data ◽  
Negative Appendectomy Rate ◽  
New Scoring

Background.Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and developing a new scoring system were aimed.Methods.Medical records of patients who were hospitalized for AA between February 2012 and October 2016 were retrospectively reviewed. All data were compared between patients with and without appendicitis. The multivariate analysis was performed to define significant variables and to examine the sensitivity and specificity of each group of predictors including radiological data. A new scoring system (NSS) was formed and was compared with two existing scoring systems: pediatric appendicitis score (PAS) and Alvarado scoring system (ASS) by using reclassification method.Results.Negative appendectomy rate was 11.3%. Statistical analysis identified 21 independently significant variables. The heel drop test had the highest odds ratio. Sensitivity and specificity rates of clinical predictors were 84.6% and 94.8%, respectively. Radiological predictors increased the sensitivity rate to 86.9%. Sensitivity and specificity rates for PAS, ASS, and NSS were 86.8% and 83.9%, 84.7% and 81.6%, and 96.8% and 95.6%, respectively. The “re-assessed negative appendectomy rate” was 6.2% and false positive results were remarkably more common in patients with duration of symptoms less than 24 hours.Conclusion.Radiological data improves the accuracy of diagnosis. Containing detailed clinical and radiological data, NSS performs superiorly to PAS and ASS, regarding sensitivity and specificity without any age limitation. The efficiency of NSS may be enhanced by determining different predictors for different phases of the inflammatory process.

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