scholarly journals HPV, p16 and p53 As Indicators of Response to Survival in Larynx Squamous Cell Carcinoma

Author(s):  
KE LIU ◽  
Jin Gao ◽  
Zhen-chao Tao ◽  
Li-ting Qian

Abstract Purpose: To analyze the relationship between the prognosis of patients with larynx squamous cell carcinoma (LSCC) and human papillomavirus (HPV) infection, p16 and p53 protein expression. Methods: All patients were treated at the department of radiation oncology, Anhui provincial hospital, between May 2005 and May 2012. The 41 consecutive patients with LSCC were treated surgically and received postoperative radiotherapy. Analyses of pathology specimen were surgically removed and performed on formalin-fixed, paraffin-embedded tissue samples. HPV DNA sequences in tumor tissues were screened by a commercial Luminex technique for HPVs and HPV-specific PCR assays. P16 and p53 protein expression were detected by immunohistochemical staining. Overall survival(OS)and progression-free survival(PFS)for HPV-positive and HPV-negative patients, p16-positive and p16-negative patients, p53-positive and p53-negative patients were estimated by Kaplan-Meier analysis. Cox regression model was used for multivariate analysis. Results: HPV-DNA was detected in 4(9.7%)of all specimens. Among them, 3 were positive for HPV-56,1 for HPV-16. With the follow-up of 3-78 months(a median of 34 months),patients with HPV-positive tumors had better overall survival than patients with HPV-positive tumors(75% vs 61%, P>0.05). Multivariate analysis by Cox regression model showed that nodal status was independent prognostic factors for patients with LSCC(P<0.05). Conclusions: HPV status is not an independent prognostic factor. Nodal status was independent prognostic factors for patients with LSCC.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15545-e15545
Author(s):  
Jinling Zhang ◽  
Xueyuan Heng ◽  
Fengyuan Che

e15545 Background: It was reported that the number of positive lymph nodes (PLN) and negative lymph nodes (NLN) resected in lymphadenectomy were both independent prognostic factors in esophageal squamous cell carcinoma (ESCC). However, it is unclear which kind of combination of them would have a stronger impact on the prognosis of the ESCC patients. Methods: A total of 229 patients with ESCC were retrospectively investigated. The Cox Proportional Hazards Model was used to investigate the relationship between the PLN or NLN and the overall survival of patients. Survival analysis was performed using the Kaplan-Meier method, and the survival difference between sub-groups were explored with log-rank tests. The cut-off number of the ratio of NLN count to PLN count resulted in an improved outcome for patients was investigated by a series of log-rank tests. Results: The numbers of PLN and NLN were both independent prognostic factors, supported by the results of Cox regression model analysis (hazard ratio [HR], 1.12, P < 0.001 and HR, 0.97, P = 0.024, respectively).The survival differences among sub-groups from N0 to N3 stage were statistically significant (P < 0.001). Analysis using a Cox regression model revealed that the number of NLN inside the thoracic cavity had a stronger impact on the prognosis compared to the number of NLN outside the thoracic cavity (HR,0.959, P = 0.042 vs.HR, 0.973, P = 0.179). As a combination analysis consisting of the number of PLN and NLN, the log-rank test result demonstrated that patients with the ratio of NLN count inside thoracic cavity to the PLN count less than 8 could achieve a better survival. Conclusions: The ratio of NLN count inside thoracic cavity to the PLN count was a independent prognostic factor.


Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4622-4622
Author(s):  
Michael Axelson ◽  
Shirisha Reddy ◽  
Crystal Lumby ◽  
Sue Sivess-Franks ◽  
Jonathan Dowell ◽  
...  

Abstract Background: Myelodyplastic syndrome (MDS) is the disease of the elderly and increasingly common in the veteran population. Here we report a single institution experience with MDS at the Dallas VA Medical Center. Patients and Method: From a period of 1998–2007, eighty three pts were identified out of which 54 pts had bone marrow (BM) biopsy proven diagnosis of MDS. Overall survival (OS) analysis with dependent variables (Age at diagnosis, IPSS Score, WHO morphologic diagnosis, number of blood and platelet transfusions required, Hb level, ANC, cytogenetics, blast percentage, BM cellularity at diagnosis) were conducted by selection method “foreward” and only these significant variables were used in the Cox regression for multivariate analysis. Methods of Kaplan and Meier were used to generate OS curves. Results: The median age of diagnosis was 74 yrs with a median follow up time of 12.5 months. The WHO morphologic subtype was RA/RARS (n=13), Del5q (n=1), RCMD/RCMDRS (n=34), RAEB1 (n=3), RAEB2 (n=1), missing (n=2). The distribution of IPSS score was 0 (n=25); 0.5 (n=15); 1.0 (n=8), 1.5 (n=4), missing (n=2). Five pts had treatment related MDS and 3 pts transformed to AML. One patient had concurrent MGUS and one patient developed multiple myeloma. At diagnosis, 23 pts had a hemoglobin (Hb) value of less than 10g/dl. Only 4 pts had ANC less than 500; sixteen pts had ANC 500–1800 and 34 pts had normal counts. A majority of pts had normal cytogenetics (n=37), 5 pts had good risk, 5 pts had intermediate risk and 7 pts had poor risk cytogenetics. Six pts had hypocellular (<30%) BM at diagnosis whereas 16 pts had a hypercellular marrow (> 50%). Only 4 pts had more than 5% blast in the BM. Twenty nine pts eventually became blood transfusion dependent and 12 pts needed platelet transfusion at some point. Thirty six pts were treated with erythropoietin (with or without neupogen) and 13 pts received some type of disease modifying therapy (5-azacytidine/lenalidomide/ATG/clinical trial). The mean survival time was 106 months. Median survival was not reached at the time of analysis. In the univariate analysis, IPSS score (p=0.003), No. of blood transfusions (p=0.028), cytogenetics (p=0.0001) and blast percentage (p=0.0015), were statistically significant. BM cellularity (p=0.06) and Hb level (p=0.09) showed a trend towards significance. On multivariate analysis, Hb greater than 10 (HR 0.08; p=0.011), abnormal cytogenetics (HR 4.2; p=0.001), BM Blast > 5% (p=0.026) and BM cellularity < 30% (HR 4.6; p=0.033) emerged as the significant predictors of overall survival. IPSS score or Blood transfusion requirement did not pan out to be significant. Conclusion: MDS in the veteran population may be different from general population and may have unique predictors of survival. A larger number of patients and longer duration of follow up is required to further evaluate these prognostic factors.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13509-13509
Author(s):  
A. Muñoz ◽  
R. Barceló ◽  
A. Gil-Negrete ◽  
S. Carrera ◽  
G. López-Argumedo ◽  
...  

13509 Background: AC is indicated for stage III and high risk stage II colon cancer, as well as for stages II-III rectal cancers combined with RT. Moreover, chemotherapy improves survival in metastatic disease. There are no randomised trials evaluating the role of systemic AC after resection of metastases from CRC. Methods: We retrospectively reviewed patients with completely (R0) removed HM and/or PM from CRC, analysing prognostic factors for overall survival, including AC. Kaplan-Meier method with log rank test was used to assess and compare survival curves. Cox regression model was applied for multivariate analysis. Results: From Jan 1993 to Jun 2004, 146 patients were identified: 98 (67%) with HM, 39 with PM (27%) and 9 (6%) with both HM and PM. Gender (M/F): 102/44. Median age: 65.5 y-o (39.3–82.6). Primary CRC: rectum 62 (42.5%), pN+ 87 (60%), stage IV at diagnosis 57 (39%). Number of metastatic nodules resected: mean 2.25 (1–10). Size of the largest metastasis: mean 4 cm (0.5–18). Mean serum CEA value before surgery 20.6 (0–332): normal 73 (50%), increased 45 (31%), missing data 28 (19%). Ninety seven patients (66.5%) received postoperative AC (5FU/LV: 81, CPT11: 15, FOLFOX 1), 10 patients were not treated because of postoperative death (1) or early progression (9), and 39 due to several causes: not referred, medical contraindication or patient refusal. Median overall survival was 46.4 m, with a 3, 5 and 7-year survival probability of 59%, 35% and 22%. At univariate analysis, number (2 vs >2) of metastases resected (60.1 vs 38.3m, p=0.0004) and AC (54.3 vs 31.2m, p=0.0001) were significant prognostic factors. Increased CEA (p=0.088), involved nodes in the primary (p=0.0618) and PM+HM (p=0.0538) showed a trend towards worse survival. In multivariate analysis (excluding patients with early death/progression) AC was associated with longer survival probability (HR 2.049, 95%CI 1.149–3.656, p=0.015). Conclusions: In our retrospective series AC seems to improve survival after resection of liver and/or lung metastases from CRC. The best use of chemotherapy (adjuvant, neoadjuvant or both) in patients with resectable metastatic CRC should be evaluated in a randomised fashion. No significant financial relationships to disclose.


2021 ◽  
Author(s):  
Yi-Wei Lin ◽  
Wei-Piao Kang ◽  
Bin-Liang Huang ◽  
Zi-Han Qiu ◽  
Lai-Feng Wei ◽  
...  

Abstract Background Tongue squamous cell carcinoma (TSCC) is a prevalent malignant disease that is characterized by high rates of metastasis and postoperative recurrence. The aim of this study was to establish a nomogram to predict the outcome of TSCC patients after surgery. Methods We retrospectively analyzed 169 TSCC patients who underwent treatments in the Cancer Hospital of Shantou University Medical College from 2008 to 2019. The Cox regression analysis was performed to determine the independent prognostic factors associated with patient’s overall survival (OS). A nomogram based on these prognostic factors was established and internally validated using a bootstrap resampling method. Results Multivariate Cox regression analysis revealed the independent prognostic factors for OS were TNM stage, age, lymphocyte-to-monocyte ratio and immunoglobulin G, all of which were identified to create the nomogram. The Akaike Information Criterion and Bayesian Information Criterion of the nomogram were lower than those of TNM stage (292.222 vs. 305.480; 298.444 vs. 307.036, respectively), indicating a better goodness-of-fit of the nomogram for predicting OS. The bootstrap-corrected of concordance index (C-index) of nomogram was 0.784 (95% CI: 0.708–0.860), which was higher than that of TNM stage (0.685, 95% CI: 0.603–0.767, P = 0.017). The results of time-dependent C-index for OS also showed that the nomogram had a better discriminative ability than that of TNM stage. The calibration curves of the nomogram showed good consistency between the probabilities and observed values. The decision curve analysis also revealed the potential clinical usefulness of the nomogram. Based on the cutoff value obtained from the nomogram, the proposed high-risk group had poorer OS than low-risk group (P < 0.0001). Conclusions The nomogram based on clinical characteristics and serological inflammation markers might be useful for outcome prediction of TSCC patient.


2020 ◽  
Author(s):  
jinling Zhang ◽  
yan Liu ◽  
hongyan Li ◽  
xinglan Li ◽  
luning Li ◽  
...  

Abstract BACKROUND: It was reported that the number of positive lymph nodes (PLN) and negative lymph nodes (NLN) resected in lymphadenectomy were both independent prognostic factors in esophageal squamous cell carcinoma (ESCC). However, it is unclear which kind of combination of them would have a stronger impact on the prognosis of the ESCC patients. METHODS: A total of 229 patients with ESCC were retrospectively investigated. The Cox Proportional Hazards Model was used to investigate the relationship between the PLN or NLN and the overall survival of patients. Survival analysis was performed using the Kaplan-Meier method, and the survival difference between sub-groups were explored with log-rank tests. The cut-off number of the ratio of NLN count to PLN count resulted in an improved outcome for patients was investigated by a series of log-rank tests. RESULTSs: The numbers of PLN and NLN were both independent prognostic factors, supported by the results of Cox regression model analysis (hazard ratio [HR], 1.12, P<0.001 and HR, 0.97, P=0.024, respectively).The survival differences among sub-groups from N0 to N3 stage were statistically significant (P<0.001). Analysis using a Cox regression model revealed that the number of NLN inside the thoracic cavity had a stronger impact on the prognosis compared to the number of NLN outside the thoracic cavity (HR,0.959, P=0.042 vs.HR, 0.973, P=0.179). As a combination analysis consisting of the number of PLN and NLN, the log-rank test result demonstrated that patients with the ratio of NLN count inside thoracic cavity to the PLN count less than 8 could achieve a better survival.CONCLUSIONS: The ratio of NLN count inside thoracic cavity to the PLN count was a independent prognostic factor.


2021 ◽  
Vol 11 ◽  
Author(s):  
Peng Tang ◽  
Chen Tan ◽  
Qingsong Pang ◽  
Chih-Wen Chi ◽  
Yuwen Wang ◽  
...  

Esophageal cancer is a common malignancy worldwide and a leading cause of cancer-related mortality. Definitive concurrent chemoradiotherapy (CCRT) has been widely used to treat locally advanced esophageal squamous cell carcinoma (ESCC). In this study, we evaluated the predictive power of a 35-gene mutation profile and radiation parameters in patients with ESCC. Data from 44 patients with ESCC who underwent definitive CCRT were retrospectively reviewed. A 35-gene mutation profile, derived from reported ESCC-specific next-generation sequencing results, and radiation dosimetry parameters were examined using the Kaplan–Meier curve and Cox proportional hazards model. All patients were native Chinese and underwent CCRT with a median follow-up time of 22.0 months. Significant prognostic factors affecting progression-free survival in the multivariable Cox regression model were clinical nodal staging ≥2 (hazard ratio, HR: 2.52, 95% CI: 1.15–5.54, p = 0.022), ≥10% lung volume receiving ≥30 Gy (V30) (HR: 2.36, 95% CI: 1.08–5.17, p = 0.032), and mutation of fibrous sheath interacting protein 2 (FSIP2) (HR: 0.08, 95% CI: 0.01–0.58, p = 0.013). For overall survival, significant prognostic factors in the multivariable Cox regression model were lung V30 ≥10% (HR: 3.71, 95% CI: 1.48–9.35, p = 0.005) and mutation of spectrin repeat containing nuclear envelope protein 1 (SYNE1) (HR: 2.95, 95% CI: 1.25–6.97, p = 0.014). Our cohort showed higher MUC17 (79.5% vs. 5.7%), FSIP2 (18.2% vs. 6.2%), and SYNE1 (38.6% vs. 11.0%) mutation rates and lower TP53 (38.6% vs. 68.7%) mutation rates than the ESCC cohorts from The Cancer Genome Atlas. In conclusion, by using a combination of a 35-gene mutation profile and radiotherapy dosimetry, mutations in FSIP2 and SYNE1 as well as lung V30 were identified as potential predictors for developing a prediction model for clinical outcomes in patients with ESCC administered definitive CCRT.


2017 ◽  
Vol 27 (9) ◽  
pp. 1804-1812 ◽  
Author(s):  
Tine H. Schnack ◽  
Estrid Høgdall ◽  
Lotte Nedergaard Thomsen ◽  
Claus Høgdall

ObjectivesWomen with endometriosis carry an increased risk for ovarian clear cell adenocarcinomas (CCCs). Clear cell adenocarcinoma may develop from endometriosis lesions. Few studies have compared clinical and prognostic factors and overall survival in patients diagnosed as having CCC according to endometriosis status.MethodsPopulation-based prospectively collected data on CCC with coexisting pelvic (including ovarian; n = 80) and ovarian (n = 46) endometriosis or without endometriosis (n = 95) were obtained through the Danish Gynecological Cancer Database. χ2 Test, independent-samples t test, logistic regression, Kaplan-Meier test, and Cox regression were used. Statistical tests were 2 sided. P values less than 0.05 were considered statistically significant.ResultsPatients with CCC and pelvic or ovarian endometriosis were significantly younger than CCC patients without endometriosis, and a higher proportion of them were nulliparous (28% and 31% vs 17% (P = 0.07 and P = 0.09). Accordingly, a significantly higher proportion of women without endometriosis had given birth to more than 1 child. Interestingly, a significantly higher proportion of patients with ovarian endometriosis had pure CCCs (97.8% vs 82.1%; P = 0.001) as compared with patients without endometriosis. Overall survival was poorer among CCC patients with concomitant ovarian endometriosis (hazard ratio, 2.56 [95% confidence interval, 1.29–5.02], in the multivariate analysis.ConclusionsAge at CCC diagnosis and parity as well as histology differ between CCC patients with and without concomitant endometriosis. Furthermore, CCC patients with concomitant ovarian endometriosis have a poorer prognosis compared with endometriosis-negative CCC patients. These differences warrant further research to determine whether CCCs with and without concomitant endometriosis develop through distinct pathogenic pathways.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16231-e16231
Author(s):  
Veronica Placencio-Hickok ◽  
Marie Lauzon ◽  
Natalie Moshayedi ◽  
Michelle Guan ◽  
Sungjin Kim ◽  
...  

e16231 Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive cancers with an estimated five-year survival rate of 10%. The dense desmoplastic stroma in PDAC contributes to its aggressive nature and treatment resistance. Among the components comprising the stroma, hyaluronan (HA) has been demonstrated to play a critical role in tumor progression and survival. Previous preliminary studies have suggested differences in HA expression in primary and metastatic foci in PDAC. However, the effects of treatment and location of HA expression as well as the role of CD44, a known receptor for HA, on HA as a biomarker signature remain unknown. Thus, we investigated the potential of HA as a biomarker in primary PDAC and metastases. Methods: PDAC tissue from primary (n = 43) and metastatic (n = 66) sites were obtained from Cedars-Sinai Medical Center along with associated clinical data. Tissue slides were stained with H&E, HA using a histochemical assay, and CD44 by immunohistochemistry. HA staining was scored according to the proportion of stromal staining at an intensity greater than the background stroma. HA status was defined as ≥ 50% staining being HA high and < 50% as being HA low. CD44 staining was recorded as an H-score (percentage of tumor cells staining multiplied by intensity of staining on a scale from 0 to 3). Associations between HA levels and the requested variables were examined with t-test, Wilcoxon rank-sum test, Chi-squared test, Fisher’s exact test, or Cox regression model where appropriate. Kaplan-Meier curves were created to assess progression free survival and overall survival. Analyses were performed using SAS 9.4 with two-sided tests and a significance level of 0.05. Results: HA score was significantly higher in primary PDAC tissue compared to sites of metastases (p = 0.0148). Within the metastases, HA score was significantly higher in liver metastasis compared to other sites of metastasis (p = 0.0478). In the liver metastasis tissue, HA score trended lower in patients with previously treated tissue compared to treatment naïve tissue (p = 0.0622). In the treatment naive liver metastasis cohort, patients with HA high status had decreased progression free survival and overall survival compared to patients with HA low status (p = 0.0032 and p = 0.0478, respectively). Using HA score and CD44 in a Cox regression model demonstrated that for every one unit increase in HA score, the risk for recurrence/progression increased by 4.4% at any fixed point in time, adjusting for CD44 score (p = 0.0049). Conclusions: HA score is variable between primary PDAC, PDAC metastatic to the liver, and PDAC metastatic to other sites. Within liver metastases, patients with HA high status had decreased progression free survival and overall survival compared to patients with HA low status. HA levels can serve as a potential biomarker to guide pancreatic cancer treatments and trial design for agents targeting the stroma.


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