Prognostic significance of preoperative plasma fibrinogen levels in primary gastrointestinal stromal tumours: a retrospective cohort study

2020 ◽  
Author(s):  
Shibo Song ◽  
Xianglong Cao ◽  
Hongda Pan ◽  
Maolin Hu ◽  
Qiuxia Yan ◽  
...  
Keyword(s):  
High Risk ◽  
Poor Prognosis ◽  
Cox Regression ◽  
Tumour Size ◽  
Characteristic Curve ◽  
Prognostic Significance ◽  
Clinicopathological Characteristics ◽  
Plasma Fibrinogen ◽  
Rank Test ◽  
Gastrointestinal Stromal Tumours

Abstract Background Improved prediction of prognosis for gastrointestinal stromal tumours (GISTs) has become increasingly important since the introduction of small molecule tyrosine kinase inhibitors. Here, we aimed to evaluate the prognostic significance of preoperative plasma fibrinogen (Fib) levels in patients with primary GISTs and to analyse their correlations with clinicopathological characteristics. Methods A total of 201 previously untreated patients with primary GISTs who had undergone radical surgery at our institution between October 2004 and July 2018 were enrolled. Patient demographics, clinicopathological characteristics, preoperative plasma Fib levels and recurrence-free survival (RFS) were analysed. The optimal cut-off value for Fib levels was calculated using time-dependent receiver operating characteristic curve analysis. RFS, the primary endpoint, was calculated by the Kaplan–Meier method and compared by the log-rank test. Univariate and multivariate Cox regression models were calculated. Results Patients in the high Fib group had a shorter RFS than those in the low Fib group (P < 0.001). In multivariate analysis, high preoperative plasma Fib levels were detected as an independent adverse prognostic factor (P = 0.008, hazard ratio 3.136, 95% CI 1.356‒7.256). Furthermore, high preoperative plasma Fib levels also indicated a poor prognosis within the modified National Institutes of Health (mNIH) high-risk subgroup (P = 0.041). In addition, preoperative plasma Fib levels showed a positive correlation with several prognostic factors and even a linear relationship with tumour size (Spearman correlation coefficient [ r ] = 0.411, P < 0.001). Conclusions High preoperative plasma Fib levels may indicate a poor prognosis in patients with primary GISTs. As a cost-effective biomarker, preoperative assessment of plasma Fib levels may help to further risk stratify patients with mNIH high-risk GISTs and instruct the application of targeted therapy.

scholarly journals Prognostic significance of preoperative plasma fibrinogen levels in primary gastrointestinal stromal tumours: a retrospective cohort study

2019 ◽  
Author(s):  
Shibo Song ◽  
Xianglong Cao ◽  
Hongda Pan ◽  
Maolin Hu ◽  
Qiuxia Yan ◽  
...  
Keyword(s):  
High Risk ◽  
Poor Prognosis ◽  
Cox Regression ◽  
Target Therapy ◽  
Tumour Size ◽  
Prognostic Significance ◽  
Plasma Fibrinogen ◽  
Rank Test ◽  
Gastrointestinal Stromal Tumours ◽  
Primary Gist

Abstract Background Improved prediction of prognosis for gastrointestinal stromal tumours (GIST) has become increasingly important since the introduction of small molecule tyrosine kinase inhibitors. Here, we aimed to evaluate the prognostic significance of preoperative plasma fibrinogen (Fib) levels in patients with primary GIST and to analyze their correlations with clinicopathological characteristics.Methods A total of 201 previously untreated patients with primary GIST who had underwent radical surgery at our institution between October 2004 and July 2018 were enrolled. Patient demographics, clinicopathological characteristics, preoperative plasma Fib levels and recurrence-free survival (RFS) were analyzed. The optimal cut-off value for Fib levels was calculated using receiver operating characteristic curve analysis. RFS, the primary endpoint, was calculated by the Kaplan–Meier method and compared by the log-rank test. Univariate and multivariate Cox regression models were calculated.Results Patients in high Fib group had a shorter RFS compared with low Fib group (P < 0.001). In multivariate analysis, high preoperative plasma Fib levels were detected as an independent adverse prognostic factor (P = 0.004, hazard ratio 3.443, 95% confidence interval 1.498‒7.916). Furthermore, high preoperative plasma Fib levels also indicated a poor prognosis within the modified National Institutes of Health (mNIH) high-risk subgroup (P = 0.013). In addition, preoperative plasma Fib levels were showed a positive correlation with several prognostic factors, and even linearly with tumour size (Spearman correlation coefficient [ r ] = 0.411, P < 0.001).Conclusions High preoperative plasma Fib levels may indicate a poor prognosis in patients with primary GIST. As a cost-effective biomarker, preoperative assessment of plasma Fib levels may help to further risk stratification for patients with mNIH high-risk GIST and instruct the application of target therapy.

scholarly journals Identification and Validation of Ubiquitin-Specific Proteases as a Novel Prognostic Signature for Hepatocellular Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Wenkai Ni ◽  
Saiyan Bian ◽  
Mengqi Zhu ◽  
Qianqian Song ◽  
Jianping Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Poor Prognosis ◽  
Cox Regression ◽  
Expression Profiles ◽  
Prognostic Significance ◽  
Cancer Genome ◽  
Advanced Tumor Stage ◽  
Genomic Alterations ◽  
Advanced Tumor

PurposeUbiquitin-specific proteases (USPs), as a sub-family of deubiquitinating enzymes (DUBs), are responsible for the elimination of ubiquitin-triggered modification. USPs are recently correlated with various malignancies. However, the expression features and clinical significance of USPs have not been systematically investigated in hepatocellular carcinoma (HCC).MethodsGenomic alterations and expression profiles of USPs were investigated in CbioPortal and The Cancer Genome Atlas (TCGA) Liver hepatocellular carcinoma (LIHC) dataset. Cox regression and least absolute shrinkage and selection operator (LASSO) analyses were conducted to establish a risk signature for HCC prognosis in TCGA LIHC cohort. Subsequently, Kaplan-Meier analysis, receiver operating characteristic (ROC) curves and univariate/multivariate analyses were performed to evaluate the prognostic significance of the risk signature in TCGA LIHC and international cancer genome consortium (ICGC) cohorts. Furthermore, we explored the alterations of the signature genes during hepatocarcinogenesis and HCC progression in GSE89377. In addition, the expression feature of USP39 was further explored in HCC tissues by performing western blotting and immunohistochemistry.ResultsGenomic alterations and overexpression of USPs were observed in HCC tissues. The consensus analysis indicated that the USPs-overexpressed sub-Cluster was correlated with aggressive characteristics and poor prognosis. Cox regression with LASSO algorithm identified a risk signature formed by eight USPs for HCC prognosis. High-risk group stratified by the signature score was correlated with advanced tumor stage and poor survival HCC patients in TCGA LIHC cohort. In addition, the 8-USPs based signature could also robustly predict overall survival of HCC patients in ICGC(LIRI-JP) cohort. Furthermore, gene sets enrichment analysis (GSEA) showed that the high-risk score was associated with tumor-related pathways. According to the observation in GSE89377, USP39 expression was dynamically increased with hepatocarcinogenesis and HCC progression. The overexpression of USP39 was further determined in a local HCC cohort and correlated with poor prognosis. The co-concurrence analysis suggested that USP39 might promote HCC by regulating cell-cycle- and proliferation- related genes.ConclusionThe current study provided a USPs-based signature, highlighting its robust prognostic significance and targeted value for HCC treatment.

scholarly journals New Circulating Circular RNAs with Diagnostic and Prognostic Potential in Advanced Colorectal Cancer

2021 ◽  
Vol 22 (24) ◽  
pp. 13283
Author(s):  
Maria Radanova ◽  
Galya Mihaylova ◽  
Oskan Tasinov ◽  
Desislava P. Ivanova ◽  
George St. Stoyanov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Clinicopathological Characteristics ◽  
Rank Test ◽  
Circular Rnas ◽  
Cox Regression Analysis ◽  
Expression Levels ◽  
The Mean ◽  
New Biomarkers

Circular RNAs (circRNAs) are a group of special endogenous long non-coding RNAs which are highly stable in the circulation, and, thus, more suitable as new biomarkers of colorectal cancer (CRC). The aim of our study was to explore the plasma expression levels of four circRNAs: has_circ_0001445, hsa_circ_0003028, hsa_circ_0007915 and hsa_circ_0008717 in patients with CRC and to evaluate their associations with clinicopathological characteristics and the clinical outcome of the patients. CircRNAs were extracted from patients’ plasma obtained prior to chemotherapy. Their expression levels were measured by qPCR and calculated applying the 2−ΔΔCt method. The levels of all four circRNAs were significantly increased in the plasma of CRC patients. At the optimal cut-off values hsa_circ_0001445 and hsa_circ_0007915 in plasma could significantly distinguish between patients with or without metastatic CRC with 92.56% sensitivity and 42.86% specificity, and with 86.07% sensitivity and 57.14% specificity, respectively. The mean overall survival (OS) of patients with high/intermediate expression of hsa_circ_0001445 was 30 months, significantly higher in comparison with the mean OS of the patients with low expression—20 months (log-rank test, p = 0.034). In multivariate Cox regression analysis, the low levels of hsa_circ_0001445 were also associated with shorter survival (HR = 1.59, 95% CI: 1.02–2.47, p = 0.040). A prognostic significance of hsa_circ_0001445 for patients with metastatic CRC was established.

scholarly journals Evaluating the effect of tumor size on survival and its prognostic significance among gastric cancer patients

2020 ◽  
Vol 5 (2) ◽  
pp. 76-82
Author(s):  
Orhan Uzun ◽  
◽  
Aziz Serkan Senger ◽  
Selçuk Gülmez ◽  
Sinan Ömeroğlu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Tumor Size ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Clinicopathological Characteristics ◽  
Rank Test ◽  
D2 Lymph Node Dissection ◽  
Large Size ◽  
Wall Invasion

Purpose. This study investigates the prognostic significance of tumor size and its effect on survival among patients undergoing gastrectomy and D2 lymph node dissection due to gastric cancer. Materials and Methods. The clinicopathological characteristics of 320 patients who were operated due to gastric cancer between November 2006 and September 2019 were assessed retrospectively, of which 271 were included in the present study. A receiver-operating characteristic curve (ROC) analysis was carried out to identify the tumor size cut-off value. Patients were divided into small-size and large-size tumor groups. Clinicopathological characteristics were assessed using Chi-square and Mann-Whitney U tests, while survival was assessed with a Kaplan-Meier log-rank test. Results. The cut-off gastric cancer tumor size value was calculated as 4.75 cm. A statistical difference was noted in the tumor depth of wall invasion (p<0.001), the number of positive lymph nodes removed (p<0.001), vascular invasion (p=0.001) and perineural invasion (p=0.001) of the two groups. Survival was poorer in patients with large-size tumors than in those with small-size tumors (62 months vs. 88 months, respectively; p<0.001), and tumor size was associated with wall invasion depth (p<0.001) and Borrmann’s classification (p=0.002). A univariate analysis revealed tumor size to be a prognostic factor for survival (p=0.001), while no such finding could be established in a multivariate analysis (p=0.637). Conclusion. Tumor size is a prognostic marker for gastric cancer, and a preoperative assessment in this regard may suggest neoadjuvant therapy.

Over-expression of Wilms' tumor 1-associating Protein Promotes Tumorigenesis and Predicts Poor Prognosis in Endometrial Cancer

2020 ◽  
Author(s):  
Wenli Xie ◽  
Naifu Liu ◽  
Xiangyu Wang ◽  
Wenyan Xie ◽  
Dapeng Li ◽  
...  
Keyword(s):  
High Risk ◽  
Signaling Pathway ◽  
Poor Prognosis ◽  
Cox Regression ◽  
Wilms Tumor ◽  
Independent Predictor ◽  
Gene Set Enrichment Analysis ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Wilms Tumor 1

Abstract Background. Wilms’ tumor 1‐associating protein (WTAP) was previously reported to play critical roles in the tumorigenesis of different malignancies, and its expression level has been linked to a poor prognosis of several cancers. We evaluated the role of WTAP in endometrial carcinoma (EC) using publicly available data from The Cancer Genome Atlas (TCGA). Methods. The relationship between WTAP expression and clinical characteristics was assessed with the Wilcoxon signed‐rank test and logistic regression. Clinical factors associated with prognosis were evaluated using Cox regression analysis and Kaplan-Meier method. Gene set enrichment analysis (GSEA) was conducted using TCGA dataset. Results. Our results revealed that WTAP was significantly up-regulated in EC. Increased WTAP expression in EC was significantly associated with high-grade tumor (odds ratio [OR] = 2.126) and high-risk histology (OR = 1.915) (all P < 0.05). Patients with high WTAP expression had a worse overall survival (OS) (hazard ratio [HR] = 2.868, 95% confidence interval [CI] = 1.259-6.532; P = 0.0087) and recurrence-free survival (RFS) (HR =3.148, 95% CI = 1.372-7.220; P = 0.004) than those with low WTAP expression. Multivariate analysis showed that WTAP expression remained an independent predictor of OS and RFS. Furthermore, GSEA showed that wnt/β-catenin signaling pathway was differentially enriched in WTAP high expression phenotype. Conclusions. WTAP was over-expressed in EC. WTAP expression was an independent predictor of poor OS and RFS in EC, and it was associated with advanced grade, high-risk EC. Moreover, the wnt/β-catenin signaling pathway might be the key process regulated by WTAP in EC.

scholarly journals Preoperative Plasma Fibrinogen and Serum Albumin Score Is an Independent Prognostic Factor for Resectable Stage II-III Gastric Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Menghui Wu ◽  
Yuchen Pan ◽  
Zhifang Jia ◽  
Yueqi Wang ◽  
Na Yang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Serum Albumin ◽  
Poor Prognosis ◽  
Response Rate ◽  
Prognostic Significance ◽  
Independent Prognostic Factor ◽  
The Other ◽  
Plasma Fibrinogen ◽  
Radical Gastrectomy

Background. Radical gastrectomy with D2 lymphadenectomy is recognized as the standard treatment for resectable advanced gastric cancer. Preoperative fibrinogen and albumin measurements may bring clinical benefits in terms of providing advanced notice of a poor prognosis or recurrence in patients undergoing radical resection. The aim of this study was to identify markers that are predictive of a poor prognosis prior to surgery. Methods. Eight hundred forty-two consecutive patients who underwent curative radical gastrectomy at our hospital between 2008 and 2012 were retrospectively reviewed. Based on plasma fibrinogen and serum albumin levels, preoperative fibrinogen and albumin scores (Fib-Alb scores) were investigated, and the prognostic significance was determined. Results. The patients were classified according to a Fib-Alb score of 0 (n=376), 1 (n=327), or 2 (n=139). When the correlation between the response rate and the change in the Fib-Alb score was investigated, the response rate was significantly lower in patients with an increased Fib-Alb score than in the other patients. In the survival analysis, patients in the Fib-Alb high-score group exhibited significantly worse recurrence-free survival (RFS) (P=0.030) than patients in the other groups. A multivariate analysis using clinical stage and the change in the Fib-Alb score as covariates revealed that a change in the Fib-Alb score (Fib-Alb score 1, HR: 1.31, 95% CI: 1.03-1.66, P=0.028; Fib-Alb score 2, HR: 1.61, 95% CI: 1.20-2.17, P=0.001) was a significant independent predictive factor for RFS. Conclusions. The prognosis of patients with high fibrinogen and low albumin levels is poor. The Fib-Alb score was shown to be an independent prognostic factor for postoperative recurrence in gastric cancer patients who underwent radical gastrectomy.

scholarly journals Downregulation of miR-29c-3p is associated with a poor prognosis in patients with laryngeal squamous cell carcinoma

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ruihua Fang ◽  
Yongjin Huang ◽  
Jinghua Xie ◽  
Jianzhong Zhang ◽  
Xiaobin Ji
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Laryngeal Cancer ◽  
Squamous Cell ◽  
Poor Prognosis ◽  
Laryngeal Squamous Cell Carcinoma ◽  
Hazard Analysis ◽  
Clinicopathological Characteristics ◽  
Rank Test

Abstract Background Laryngeal squamous cell carcinoma (LSCC) is considered to be a common malignancy of the head and neck with poor prognosis for its late diagnosis, metastasis and recurrence. Growing evidence demonstrates that the dysregulation of miR-29c-3p (microRNA-29c-3p) plays an important role in various tumor processes. Our study investigates the expression of miR-29c-3p in LSCC and analyzes the correlation of its dysregulation with clinicopathologic parameters and prognosis. Methods The expression of hsa-miR-29c-3p in LSCC tissues and the adjacent normal laryngeal tissues was detected in 96 LSCC formalin-fixed paraffin-embedded tissues by quantitative real-time PCR (qRT-PCR). The SPSS statistical software package (17.0) was used to analyze the associations between miR-29c-3p expressions and various clinicopathological characteristics. The overall survival (OS) was analyzed by the Kaplan-Meier method and log-rank test, and we analyzed the independent factor of prognosis by Cox proportional hazard analysis. Results A downregulation of miR-29c-3p expression in LSCC was significantly correlated with smoking index, tumor size, tumor site, differentiation, T classification, TNM stage, and lymph node metastasis (P < 0.05), but there was no correlation with age and alcohol consumption (P > 0.05). In the multivariate survival analysis, low miR-29c-3p expression was associated with shorter overall survival (P < 0.05). Furthermore, miR-29c expression was an independent prognostic factor for laryngeal cancer patients. Conclusions MiR-29c-3p has different expression levels at different stages of tumor progression, suggesting that miR-29c-3p may be a promising biomarker for evaluating the progression of LSCC and the prognosis of patients with LSCC. MiR-29c-3p can also be a novel molecular target for anti-laryngeal cancer therapy.

Adrenocortical Carcinoma: Clinical, Morphologic, and Molecular Characterization

2002 ◽  
Vol 20 (4) ◽  
pp. 941-950 ◽  
Author(s):  
Alexander Stojadinovic ◽  
Ronald A. Ghossein ◽  
Axel Hoos ◽  
Aviram Nissan ◽  
David Marshall ◽  
...  
Keyword(s):  
Adrenocortical Carcinoma ◽  
Cox Regression ◽  
Expression Profiles ◽  
Expression Patterns ◽  
Prognostic Significance ◽  
Phenotypic Expression ◽  
Patient Specific ◽  
Rank Test ◽  
Primary Tumors ◽  
Adrenal Tissue

PURPOSE: To define multimolecular phenotypes of adrenocortical carcinoma (ACC) and to correlate outcome with morphologic and molecular parameters. PATIENTS AND METHODS: Clinical data were analyzed for 124 patients, histopathologic slides for 67 primary tumors, and tissue specimens for 74 patients (38 primary and 36 metastatic tumors) with ACC and for 38 normal adrenal tissue samples. Molecular expression profiles were investigated by immunohistochemistry. The prognostic significance of 12 gross and histologic parameters in 67 primary ACCs was evaluated. Morphologic and protein expression patterns were correlated with disease-specific survival (DSS). Univariate influence of prognostic factors on DSS was analyzed by log-rank test and multivariate analysis by Cox regression. RESULTS: The median follow-up period was 4.7 years. Significant predictors of DSS included distant metastasis at time of initial presentation; venous, capsular, and adjacent organ invasion; tumor necrosis, mitotic rate, atypical mitosis, and mdm-2 overexpression. Five-year DSS by number (one to six) of adverse histologic parameters was as follows: one to two, 84%; three to four, 37%; more than four, 9% (P = .005).The phenotype Ki-67(−)p53(−)mdm-2(+)cyclinD1(−)Bcl-2(−)p21(−)p27(+) was observed in 83% of normal and 3% of malignant adrenal tissue (P = .01). Molecular phenotypic expression was more heterogeneous in malignant than in normal (10 v five phenotypes) adrenal tissue. CONCLUSION: Meticulous morphologic evaluation, mitotic count, and tumor stage are essential in determining prognosis for patients with ACC. Multimolecular phenotyping demonstrates that the molecular complexity and heterogeneity of these neoplasms are such that targeted therapy needs to be patient specific.

Markers of angiogenesis in cervical cancer: A Gynecologic Oncology Group study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5536-5536
Author(s):  
L. Randall-Whitis ◽  
B. J. Monk ◽  
E. S. Han ◽  
K. Darcy ◽  
R. A. Burger ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Cox Regression ◽  
Gynecologic Oncology ◽  
Positive Control ◽  
Rank Test ◽  
Gynecologic Oncology Group ◽  
Continuous Variables ◽  
Histologic Subtype ◽  
Cd 31

5536 Background: Extensive tumor angiogenesis has correlated with poorer progression-free and overall survival in cervical cancer; however, specific markers of angiogenesis have not been studied prospectively. Methods: Cervical cancer patients with high-risk features on radical hysterectomy were eligible for randomization to adjuvant pelvic irradiation ± radiosensitizing platinum. Following central pathology review, formalin-fixed, paraffin-embedded tumors were sectioned into 4-micron specimens. Semi-quantitative immunohistochemisty (IHC) was performed using previously validated antibodies against mutant p53 (mp53), vascular endothelial growth factor (VEGF), thrombospondin-1 (TSP-1), and endothelial markers CD 31 and CD 105. Tumoral histoscores (HS) were calculated for mp53 and VEGF using the formula: [% cells positive × (intensity +1)], with a 5% threshold for positivity and intensity ranging 1–4+ (3+ = intensity of positive control). Intensity scores (0–4+) were assigned to TSP-1 specimens referencing the positive control (3+). MVD “hotspots” were counted in a 20X high-power field. HS and MVD counts were considered as continuous variables and TSP-1 intensity as an ordinal variable. Associations between markers were determined by Pearson’s and Spearman’s correlation tests, between markers and clinico-pathologic variables by Wilcoxon rank test, and between markers and survival by Cox regression modeling. Results: One hundred seventy-six specimens were analyzed. Acquisition of mp53 and increased VEGF expression were associated with increased MVD assessed by both CD31 (p=0.08 and p=0.002, respectively) and CD105 (p=0.02 and p=0.012, respectively). Statistically significant associations between markers and high-risk pathologic factors included: low-level TSP-1 and high CD-105 counts with lymph node metastases; high VEGF scores with advanced stage, non-squamous histologic subtype, and depth of tumor invasion; and high CD 31 counts with parametrial metastases. Survival analysis is currently being performed. Conclusions: Angiogenesis occurs early in cervical carcinogenesis, and may be a rational target for biologic therapy in cervical cancer. No significant financial relationships to disclose.

Gene scoring model to predict recurrence in low- and intermediate-risk uterine endometrial cancer: Establishment of uterine print.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5590-5590
Author(s):  
Tatsuyuki Chiyoda ◽  
Yoichi M Ito ◽  
Fumio Kataoka ◽  
Wataru Yamagami ◽  
Hiroyuki Nomura ◽  
...  
Keyword(s):  
Gene Expression ◽  
High Risk ◽  
Expression Profiles ◽  
Characteristic Curve ◽  
High Risk Group ◽  
Internal Controls ◽  
Rank Test ◽  
Test Cases ◽  
Intermediate Risk ◽  
Scoring Model

5590 Background: Endometrial cancers (ECs) classified as low-, intermediate-, and high-risk, based on clinical and pathological features (CPF: Lurain, 2007) associated with 5%, 15%, and 25% risk of recurrence, respectively. The need for adjuvant chemotherapy in intermediate-risk patients is controversial. We examined whether gene expression profiling can more accurately predict the prognosis of ECs, excluding the CPF-based high-risk group. Methods: Tumor specimens were obtained from 136 ECs including 14 recurrences, excluding high-risk cases. Gene expression profiles were achieved using a custom array consisting of 85 genes associated with EC recurrence and 20 internal controls that were previously screened. We established the gene scoring model (GSM) for recurrence by the logistic regression model in randomly selected 68 ECs including 7 recurrences, and evaluated the accuracy of GSM in other 68 ECs including 7 recurrences. This process was repeated 100 times. We calculated the mean accuracy of GSM and compared it with the accuracy of CPF. We also compared GSM and CPF with respect to progression-free survival (PFS) by use of the log-rank test. Results: Median age of all cases was 58 (29-86) years, and stage, histologic grade, and risk classification based on CPF were as follows: (I, 107; II, 15; III, 14), (G1, 69; G2, 57; G3, 10), and (low, 67; intermediate, 69). The median follow-up period was 1830 (1626-3444) days. The GSM was established based on the expression of 4 genes (PRCC, SPC25, PXDN, and LBXCOR1) and 10 internal controls. The area under the receiver operating characteristic curve of GSM to predict recurrence was 0.87 in 68 test cases. Based on the CPF, 68 cases were classified as 30 low-risk and 38 intermediate-risk, and the sensitivity and specificity of CPF was 86% and 48% each in the 68 test cases. When sensitivity of GSM was fixed at 86%, specificity of 67% was achieved, and 68 cases were classified as 42 risk (-) and 26 risk (+). PFS was significantly related with GSM (p = 0.006); however, it was not related with CPF (p = 0.09). Conclusions: GSM can predict the prognosis of ECs (low- and intermediate-risk) more precisely than CPF.

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