TERT Mutations Correlated With the Prognosis of Patients With Hepatitis B-Related Hepatocellular Carcinoma Underwent Curative Hepatectomy

Abstract Background To explore the value of TERT mutations in predicting the early recurrence and prognosis of hepatitis B-related hepatocellular carcinoma (HCC) patients underwent curative hepatectomy.Methods A total of 81 patients with hepatitis B-related HCC were enrolled and all patients underwent curative hepatectomy. Associations were sought between TERT mutations and recurrence rate within 2 years after hepatectomy, time to progress (TTP) and overall survival (OS).Results TERT mutations (HR: 2.985, 95%CI: 1.158-7.692, p=0.024) and Barcelona clinic liver (BCLC) stage B (HR: 3.326, 95%CI: 1.019-10.856, p=0.046) were independent risk factors for recurrence within 2 years after hepatectomy. Patients with a TERT mutation had poor TTP (p=0.003) and OS (p=0.013) than others. TERT mutations (HR: 2.245, 95%CI: 1.185-4.252, p=0.013) and BCLC stage B (HR: 2.132, 95%CI: 1.082-4.198, p=0.029) were independent risk factors for poor TTP after curative hepatectomy. A predictive model based on TERT mutations and BCLC stage had better ability to predict early recurrence after hepatectomy of HCC patients than any single factor (AUC: 0.688 vs. 0.639, 0.688 vs. 0.607, respectively). Patients with both TERT mutations and BCLC stage B had poorer TTP and OS than others (p=0.001, p<0.001, respectively).Conclusion TERT mutations had ability to predict early recurrence and poor prognosis for hepatitis B-related HCC patients underwent curative hepatectomy.

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Inflammatory indexes in preoperative blood routine to predict early recurrence of hepatocellular carcinoma after curative hepatectomy

BMC Surgery ◽

10.1186/s12893-021-01180-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

YiFeng Wu ◽

ChaoYong Tu ◽

ChuXiao Shao

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Tumour Size ◽

Area Under The Curve ◽

Early Recurrence ◽

Recurrence Free Survival ◽

Free Survival ◽

Lymphocyte Ratio ◽

Inflammatory Index ◽

Curative Hepatectomy

Abstract Background The inflammation indexes in blood routine play an essential role in evaluating the prognosis of patients with hepatocellular carcinoma, but the effect on early recurrence has not been clarified. The study aimed to investigate the risk factors of early recurrence (within 2 years) and recurrence-free survival after curative hepatectomy and explore the role of inflammatory indexes in predicting early recurrence. Methods The baseline data of 161 patients with hepatocellular carcinoma were analyzed retrospectively. The optimal cut-off value of the inflammatory index was determined according to the Youden index. Its predictive performance was compared by the area under the receiver operating characteristic curve. Logistic and Cox regression analyses were used to determine the risk factors of early recurrence and recurrence-free survival. Results The area under the curve of monocyte to lymphocyte ratio (MLR) for predicting early recurrence was 0.700, which was better than systemic inflammatory response index (SIRI), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and systemic immune-inflammatory index (SII). MLR, tumour size, tumour differentiation and BCLC stage are all risk factors for early recurrence and recurrence-free survival of HCC. Combining the above four risk factors to construct a joint index, the area under the curve for predicting early recurrence was 0.829, which was better than single MLR, tumour size, tumour differentiation and BCLC stage. Furthermore, with the increase of risk factors, the recurrence-free survival of patients is worse. Conclusion The combination of MLR and clinical risk factors is helpful for clinicians to identify high-risk patients with early recurrence and carry out active postoperative adjuvant therapy to improve the prognosis of patients.

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RAD50 predicts the prognosis of hepatitis B virus-related hepatocellular carcinoma

10.21203/rs.2.11886/v2 ◽

2020 ◽

Author(s):

Wangrui Liu ◽

Wenhao Xu ◽

Yuyan Chen ◽

Liugen Gu ◽

Xiaolei Sun ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Differential Expression ◽

Poor Prognosis ◽

Disease Free Survival ◽

Partial Likelihood ◽

Cox Regression Analysis ◽

B Virus

Abstract Background Increasing evidence indicates that RAD50, which is involved in the DNA double-strand break (DSB) repair process, is also involved in cancer outcomes. However, its role in hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) remains unclear.Aim This study was designed to investigate the expression of RAD50 and its prognostic value in HCC patients.Method A total of 207 patientswith HBV-associated HCCfrom two cohorts (107 and 100 patientsfrom the Affiliated Hospital of Youjiang Medical University of Nationalities and the Affiliated Hospital of Nantong University, respectively) were enrolled in the current study.The distribution of the categorical clinical-pathological data and the levels of RAD50 expression were compared with a χ 2 test. IHC staining of RAD50 was performed.A partial likelihood test based onunivariate and multivariate Cox regression analysis was developed to address the influence of independent factors on disease-free survival (DFS) and overall survival (OS). The Oncomine online database was used to analyse and validate the differential expression of RAD50. The Kaplan-Meier method and a log-rank test were performed to assess the influence of RAD50 on survival at different levels.Results RAD50 was highly expressed in HCC tissues compared to normal tissues and was significantly correlated with OS in the TCGA cohort. The validation analysis indicated that significantly increased levels of RAD50 were expressed in HCC tissues in the two independent cohorts, AHYMUN and AHNTU. In addition, HCC patients with elevated RAD50 expression levels showed poor OS and DFSin the AHYMUN cohort and decreased OS and DF Sin the AHNTU cohort. Furthermore, four datasets obtained from the Oncomine database validated the analysis of the differential expression of RAD50 in HCC tumours and normal tissues.Discussion In our study, we demonstrated that RAD50 was positively correlated with poor prognosis in HCC patients in the TCGA cohort. Our study also suggested that increased RAD50 expression in HBV-related HCC is a marker of poor prognosis. In this study, the analysis of the data form the two cohorts supported our hypothesis and clearly demonstrated thehigh expression of RAD50 in tumour tissues from HCC patients, which results inincreases in the HCC recurrence rate and poor overall survival.

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Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

International Journal of Nephrology ◽

10.1155/2012/385274 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Shingo Hatakeyama ◽

Masaaki Saito ◽

Kumiko Ishigaki ◽

Hayato Yamamoto ◽

Akiko Okamoto ◽

...

Keyword(s):

Risk Factors ◽

Overall Survival ◽

Lower Limb ◽

Poor Prognosis ◽

Perfusion Pressure ◽

Hemodialysis Patients ◽

Smoking History ◽

Skin Perfusion ◽

Skin Perfusion Pressure ◽

Independent Risk Factors

Peripheral arterial disease (PAD) is common in hemodialysis patients and predicts a poor prognosis. We conducted a prospective cohort study to identify risk factors for PAD including skin perfusion pressure (SPP) in hemodialysis patients. The cohort included 373 hemodialysis patients among 548 patients who received hemodialysis at Oyokyo Kidney Research Institute, Hirosaki, Japan from August 2008 to December 2010. The endpoints were lower limb survival (peripheral angioplasty or amputation events) and overall survival of 2 years. Our results showed that <70 mmHg SPP was a poor prognosis for the lower limb survival and overall survival. We also identified age, history of cardiovascular disease, presence of diabetes mellitus, smoking history, and SPP < 70 mmHg as independent risk factors for lower limb survival and overall survival. Then, we constructed risk criteria using the significantly independent risk factors. We can clearly stratify lower limb survival and overall survival of the hemodialysis patients into 3 groups. Although the observation period is short, we conclude that SPP value has the potential to be a risk factor that predicts both lower limb survival and the prognosis of hemodialysis patients.

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Risk factors and patterns of early recurrence after curative hepatectomy for hepatocellular carcinoma

Surgical Oncology ◽

10.1016/j.suronc.2015.12.002 ◽

2016 ◽

Vol 25 (1) ◽

pp. 24-29 ◽

Cited By ~ 42

Author(s):

Fumitoshi Hirokawa ◽

Michihiro Hayashi ◽

Mitsuhiro Asakuma ◽

Tetsunosuke Shimizu ◽

Yoshihiro Inoue ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Early Recurrence ◽

Curative Hepatectomy

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Early Normalization of Alanine Aminotransferase during Antiviral Therapy Reduces Risk of Hepatocellular Carcinoma in HBV Patients

Journal of Clinical Medicine ◽

10.3390/jcm10091840 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1840

Author(s):

Sehwa Kim ◽

Yoonseok Lee ◽

Soo Min Bang ◽

Haein Bak ◽

Sun Young Yim ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Alanine Aminotransferase ◽

Antiviral Treatment ◽

Antiviral Agents ◽

Independent Risk Factors

Potent antiviral agents effectively reduce liver-related events in patients with chronic hepatitis B. This study aimed to determine whether alanine aminotransferase normalization using potent antiviral agents was related to hepatocellular carcinoma development. From 2007 to 2017, we included 610 patients with chronic hepatitis B who received entecavir or tenofovir disoproxil fumarate. The patients were divided into the alanine aminotransferase normalization group (Gr.1) and non-normalization group (Gr.2) within a year of potent antiviral treatment. Liver-related events included hepatic encephalopathy, variceal bleeding, and ascites. The mortality rate and hepatocellular carcinoma incidence were investigated for each group. The patients who showed ALT normalization at 1 year of treatment were 397 (65.1%) of 610. During a median follow-up period of 86 months, 65 (10.7%) patients developed hepatocellular carcinoma. The cumulative incidence of hepatocellular carcinoma was significantly lower in Gr.1 than in Gr.2 (p < 0.001). Risk factors for alanine aminotransferase non-normalization were body mass index, cholesterol, and liver cirrhosis at baseline. Male sex, age, platelet level, alcohol use, presence of cirrhosis at baseline, and non-normalization after 1 year of treatment were independent risk factors for hepatocellular carcinoma. Alanine aminotransferase normalization within 1 year of initiating antiviral agents reduces the risk of hepatocellular carcinoma development.

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Diabetes mellitus indicate poor prognosis in uterine serous cancer patients

10.21203/rs.3.rs-261282/v1 ◽

2021 ◽

Author(s):

Yunyun Liu ◽

Jing Li ◽

Zhibo Cheng ◽

Guocai Xu ◽

Yongpai Peng ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Overall Survival ◽

Prognostic Factors ◽

Poor Prognosis ◽

Cox Regression ◽

Figo Stage ◽

Chi Square ◽

Institutional Review ◽

Independent Risk Factors

Abstract Purpose. We aimed to find prognostic factors for uterine serous cancer(USC) patients in a retrospective study.Methods. 51 USC patients between 2010-2020 were enrolled. All pathological specimens were reviewd. The research protocol was approved by Institutional Review Board and all patients were informed consent before the study began. Statistics were done using SPSS 25.0, T test and chi-square analyses were used to compare differences, the overall survival(OS) was estimated with Kaplan-Meier(KM) analysis, univariate and multivariate Cox regression analyses were utilized to find prognostic factors.Results. The median overall survival(OS) and progressive free survival(PFS) were 75.94 and 63.49 months, respectively. Diagnosed with diabetes mellitus(P=0.006, HR=6.792, 95%CI=1.726-26.722) and CA125＞28U/ml(P=0.006, HR=7.136, 95%CI=1.780-28.607) before surgery were independent risk factors for OS, advanced FIGO stage(P=0.001, HR=10.628, 95%CI=2.894-39.026) and DM(P=0.003, HR=6.327, 95%CI=1.875-21.354) were independent factors for PFS. Age≤52, , tumor size≥2.5cm and cervical mucosal infiltration may indicate poor prognosis but were not independent risk factors. Hypertension patients with routine medical treatment tend to survive longer, but there was no statistical differences in OS and PFS compared to patients with normal blood pressure.Conclusion. In addition to surgical and adjuvant treatments, gynecologists should focus more on the comorbid conditions of USC patiens, especially for DM.

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Development of TACE Refractoriness Scores in Hepatocellular Carcinoma

Frontiers in Molecular Biosciences ◽

10.3389/fmolb.2021.615133 ◽

2021 ◽

Vol 8 ◽

Author(s):

Li Chen ◽

Chen-Xi Yu ◽

Bin-Yan Zhong ◽

Hai-Dong Zhu ◽

Zhi-Cheng Jin ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Overall Survival ◽

Median Overall Survival ◽

Validation Cohort ◽

Transarterial Embolization ◽

Median Number ◽

Study Cohort ◽

Japan Society ◽

Independent Risk Factors

Purpose: To identify the independent risk factors for transarterial embolization (TACE) refractoriness and to develop a novel TACE refractoriness score and nomogram for predicting TACE refractoriness in patients with hepatocellular carcinoma (HCC).Methods: Between March 2006 and March 2016, HCC patients who underwent TACE monotherapy as initial treatment at two hospitals formed the study cohort and validation cohort. The criteria of TACE refractoriness followed the Japan Society of Hepatology 2014 version of TACE refractoriness. In the study cohort, the independent risk factors for TACE refractoriness were identified, and TACE refractoriness score and nomogram were then developed. The accuracy of the systems was validated externally in the validation cohort.Results: In total, 113 patients from hospital A formed the study cohort and 122 patients from hospital B formed the validation cohort. In the study cohort, 82.3% of the patients (n = 93) developed TACE refractoriness with a median overall survival (OS) of 540 days (95% CI, 400.8–679.1), and the remaining 20 patients in the TACE-non-refractory group had a median OS of 1,257 days (95% CI, 338.8–2,175.2) (p = 0.019). The median time for developing TACE refractoriness was 207 days (95% CI, 134.8–279.2), and a median number of two TACE procedures were performed after refractoriness developed. The independent risk factors for TACE refractoriness were the number of tumors and bilobular invasion of HCC. TACE refractoriness scores <3.5 indicated a lower incidence of TACE refractoriness, whereas scores >3.5 points indicated a higher incidence (p < 0.001). In the validation cohort, 77.9% of the patients (n = 95) developed TACE refractoriness with a median OS of 568 days (95% CI, 416.3–719.7), and a median OS of 1,324 days was observed in the TACE-non-refractory group (n = 27; 95% CI, 183.5–2,464.5).Conclusions: TACE refractoriness impairs the OS of HCC patients. The number of tumors and bilobular invasion status were independent risk factors for TACE refractoriness. The TACE refractoriness score can be an effective tool and easy approach to predict the risk of TACE refractoriness status.

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