scholarly journals Preoperative prealbumin-to-fibrinogen ratio predict Survival Outcomes in hepatocellular carcinoma patients after hepatic resection

2021 ◽  
Author(s):  
Yan Haixi ◽  
Chen Shuaishuai ◽  
Yang Qiong ◽  
Cai Linling
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Cox Regression ◽  
Laboratory Data ◽  
Disease Free Survival ◽  
Factors Affecting ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Clinicopathologic Factors ◽  
Independent Risk Factors

Objective: This study aims to evaluate the clinical application of preoperative prealbumin-to-fibrinogen ratio (PFR) in the clinical diagnosis and prognostic value of hepatocellular carcinoma (HCC) patients. Methods: The clinical and laboratory data of 269 HCC patients undergoing surgical treatment from January 2012 to January 2017 in Taizhou Hospital were retrospectively analyzed. The Cox regression model was used to analyze the correlation between PFR and other clinicopathologic factors in overall survival (OS) and disease-free survival (DFS). Results: Cox regression analysis showed that PFR (hazard ratios [HR] = 2.123; 95% confidence interval [95% CI], 1.271–3.547; P = 0.004)was independent risk factors affecting the OS of HCC patients. Furthermore, a nomogram was built based on these risk factors. The C indices statistics for the OS nomogram was 0.715. Conclusion: Nomograms based on PFR can be recommended as the correct and actual model to evaluate prognosis for patients with HCC.

scholarly journals PD-L1+NEUT, Foxp3+Treg, and NLR as New Prognostic Marker with Low Survival Benefits Value in Hepatocellular Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110458
Author(s):  
Lin Zhou ◽  
Jing Wang ◽  
Shao-cheng Lyu ◽  
Li-chao Pan ◽  
Xian-jie Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Peripheral Blood ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Rank Test ◽  
Cancer Tissue ◽  
Cox Regression Analysis ◽  
Poorly Differentiated ◽  
Independent Risk Factors

Background: This presented study was aimed to evaluate the diagnostic and prognostic value of PD-L1+Neutrophils (PD-L1+NEUT) and neutrophil to lymphocyte ratio (NLR) based on our previous experience of Foxp3+Treg in transplantation. Methods: the NLR cutoff value of 1.79 was used to include 136 cases from the 204 patients with hepatocellular carcinoma (HCC) confirmed by clinical pathology, which were divided into highly-moderately and poorly differentiated HCC groups. The expressions of PD-L1+NEUT and Foxp3+Treg in peripheral blood and cancer tissue were detected with flow cytometry, meanwhile, PD-L1 and Foxp3 expressed in carcinoma and para-carcinoma tissues were marked by immunohistochemistry. Survival rates, including overall survival and disease-free survival, were calculated by the Kaplan–Meier curve and evaluated with the log-rank test. Finally, Cox risk regression model was used to analyze the independent risk factors for prognostic survival. Results: The level of PD-L1+NEUT, Foxp3+Treg, and NLR in peripheral blood of patients with poorly differentiated HCC were significantly increased (all P < .001). Both PD-L1+NEUT and NLR were positively correlated with Foxp3+Treg ( r = 0.479, P = .0017; r = 0.58, P < .0001). The level of PD-L1+NEUT and Foxp3+Treg as well as PD-L1 and Foxp3 in cancer tissue and patients with poorly differentiated HCC were obviously increased (all P < .01), respectively. Cox regression analysis indicated that PD-L1+NEUT, NLR, and Foxp3+Treg were independent risk factors for the prognosis ( P = .000, .000, .006) with a RR and 95%CI of 2.704-(2.155-3.393), 3.139-(2.361-4.173), 1.409-(1.105-1.798), respectively. Conclusion: PD-L1+NEUT, NLR, and Foxp3+Treg are independent risk factors for prognosis which maybe new marker of lower survival benefits.

scholarly journals A Prognostic Model for Patients With Gastric Signet Ring Cell Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110279
Author(s):  
Qinping Guo ◽  
Yinquan Wang ◽  
Jie An ◽  
Siben Wang ◽  
Xiushan Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Training Set ◽  
Cox Regression Analysis ◽  
Signet Ring ◽  
Ring Cell ◽  
Independent Risk Factors

Background: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). Methods: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. Results: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. Conclusion: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.

Development and Validation of Prognostic Nomograms Predicting Recurrence and Survival in Patients with Solitary Hepatocellular Carcinoma Following Curative Liver Resection

2021 ◽  
Author(s):  
Xinxin Chen ◽  
Wenxia Qiu ◽  
Xuekun Xie ◽  
Zefeng Chen ◽  
Zhiwei Han ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Clinicopathological Characteristics ◽  
Tumor Diameter ◽  
Cox Regression Analysis ◽  
Tumor Capsule ◽  
Calibration Curves ◽  
Solitary Hepatocellular Carcinoma

Abstract Background: This work was designed to establish and verify our nomograms integrating clinicopathological characteristics with hematological biomarkers to predict both disease-free survival (DFS) and overall survival (OS) in solitary hepatocellular carcinoma (HCC) patients following hepatectomy.Methods: We scrutinized the data retrospectively from 414 patients with a clinicopathological diagnosis of solitary HCC from Guangxi Medical University Cancer Hospital (Nanning, China) between January 2004 and December 2012. Following the random separation of the samples in a 7:3 ratio into the training set and validation set, the former set was assessed by Cox regression analysis to develop two nomograms to predict the 1-year and 3-year DFS and OS (3-years and 5-years). This was followed by discrimination and calibration estimation employing Harrell’s C-index (C-index) and calibration curves, while the internal validation was also assessed.Results: In the training cohort, the tumor diameter, tumor capsule, macrovascular invasion, and alpha-fetoprotein (AFP) were included in the DFS nomogram. Age, tumor diameter, tumor capsule, macrovascular invasion, microvascular invasion, and aspartate aminotransferase (AST) were included in the OS nomogram. The C-index was 0.691 (95% CI: 0.644-0.738) for the DFS-nomogram and 0.713 (95% CI: 0.670-0.756) for the OS-nomogram. The survival probability calibration curves displayed a fine agreement between the predicted and observed ranges in both data sets. Conclusion: Our nomograms combined clinicopathological features with hematological biomarkers to emerge effective in predicting the DFS and OS in solitary HCC patients following curative liver resection. Therefore, the potential utility of our nomograms for guiding individualized treatment clinically and monitor the recurrence monitoring in these patients.

scholarly journals Surgical Resection Significantly Promotes the Overall Survival of Patients with Hepatocellular Carcinoma: A Propensity Score Matching Analysis

2021 ◽  
Author(s):  
Pei-Min Hsieh ◽  
Hung-Yu Lin ◽  
Chao-Ming Hung ◽  
Gin-Ho Lo ◽  
I-Cheng Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Surgical Resection ◽  
Cox Regression ◽  
Survival Rates ◽  
Hbv Infection ◽  
Cox Regression Analysis

Abstract Background: The benefits of surgical resection (SR) for various Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma (HCC) remain unclear. We investigated the risk factors of overall survival (OS) and survival benefits of SR over nonsurgical treatments in patients with HCC of various BCLC stages.Methods: Overall, 2316 HCC patients were included, and their clinicopathological data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed.Results: In total, 66 (2.8%), 865 (37.4%), 575 (24.8%) and 870 (35.0%) patients had BCLC stage 0, A, B, and C disease, respectively. Furthermore, 1302 (56.2%) of all patients, and 37 (56.9%), 472 (54.6%), 313 (54.4%) and 480 (59.3%) of patients with BCLC stage 0, A, B, and C disease, respectively, died. The median follow-up duration time was 20 (range 0-96) months for the total cohort and was subdivided into 52 (8-96), 32 (1-96), 19 (0-84), and 12 (0-79) months for BCLC stages 0, A, B, and C cohorts, respectively. The risk factors for OS were 1) SR and cirrhosis; 2) SR, cirrhosis, and Child-Pugh (C-P) class; 3) SR, hepatitis B virus (HBV) infection, and C-P class; and 4) SR, HBV infection, and C-P class for the BCLC stage 0, A, B, and C cohorts, respectively. Compared to non-SR treatment, SR resulted in significantly higher survival rates in all cohorts. The 5-year OS rates for SR vs non-SR were 44.0% vs 28.7%, 72.2% vs 42.6%, 42.6% vs 36.2, 44.6% vs 23.5%, and 41.4% vs 15.3% (all p-values<0.05) in the total and BCLC stage 0, A, B, and C cohorts, respectively. After PSM, SR resulted in significantly higher survival rates compared to non-SR treatment in various BCLC stages.Conclusion: SR conferred significant survival benefits to patients with HCC of various BCLC stages and should be considered a recommended treatment for select HCC patients, especially patients with BCLC stage B and C disease.

Coexpression of PDGFR-Alpha, PDGFR-Beta and VEGF as a Prognostic Factor in Patients with Hepatocellular Carcinoma

2011 ◽  
Vol 26 (2) ◽  
pp. 108-116 ◽  
Author(s):  
Li Chen ◽  
Yan Shi ◽  
Cheng-ying Jiang ◽  
Li-xin Wei ◽  
Ya-li Lv ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Growth Factor ◽  
Proportional Hazards Model ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Hazard Ratio ◽  
Cox Proportional Hazards Model ◽  
Cox Regression Analysis

Aims To evaluate the prognostic value of vascular endothelial growth factor (VEGF), platelet-derived growth factor receptor-alpha (PDGFR-α) and beta (PDGFR-β) expression in patients with hepatocellular carcinoma (HCC). Methods The expression of PDGFR-α, PDGFR-β and VEGF in 63 HCC patients who underwent curative resection was examined by immunohistochemistry (IHC). The correlations between the expression of these biomarkers and the clinicopathological characteristics were analyzed. Patient survival was analyzed by univariate analysis and Cox proportional hazards model. Results Univariate survival analysis showed that PDGFR-α or PDGFR-β overexpression was of no prognostic significance in predicting disease-free survival (DFS) and overall survival (OS) (p>0.05), while VEGF overexpression and PDGFR-α/PDGFR-β/VEGF coexpression were significantly correlated with worse DFS and poorer OS in HCC patients (P<0.05). More importantly, PDGFR-α/PDGFR-β/VEGF coexpression was an independent prognostic marker for poor survival as indicated by multivariate Cox regression analysis (DFS, hazard ratio 3.122, p=0.001; OS, hazard ratio 4.260, p=0.000). Conclusions Coexpression of PDGFR-α, PDGFR-β and VEGF could be considered an independent prognostic biomarker for predicting DFS and OS in HCC patients. This result could be used to identify patients at a higher risk of tumor recurrence and poor prognosis, and help to select therapeutic schemes for the treatment of HCC.

scholarly journals Impact of Metabolic Syndrome on the Development of Cardiovascular Disease among Kazakhs in Remote Rural Areas of Xinjiang, China: A Cohort Study

2020 ◽  
Author(s):  
Wenwen Yang ◽  
Shuxia Guo ◽  
Haixia Wang ◽  
Yu Li ◽  
Xianghui Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Rural Areas ◽  
Cox Regression ◽  
Baseline Survey ◽  
Minority Populations ◽  
Cox Regression Analysis ◽  
Independent Risk Factors

Abstract Background: Metabolic syndrome (MS) could promote the development of cardiovascular disease(CVD). The aim of this study was to examine the association of MS and its components with CVD among Kazakhs in Xinjiang. Methods: According to the geographical distribution of the minority populations in Xinjiang, we selected the representative prefecture (Yili). A total of 2,644 participants completed the baseline survey between April 2010 and December 2012. The follow-up survey was conducted from April 2016 to December 2016. Only 2,286 out of 2,644 participants were followed-up on, with a follow-up rate of 86.46%. Cox regression was used to evaluate the association of each component and the number of combinations of MS components on the development of CVD. Results: Multivariate Cox regression analysis showed that blood pressure (BP), waist circumference (WC), and triglycerides (TG) were independently associated with CVD. Participants with 1–5 MS components had an increased hazard ratio for developing CVD, from 1.82 to 8.59 (trend P<0.001), compared with those without any MS components. This trend persisted after adjusting for other general risk factors. The risk of developing CVD increased when TG and WC coexisted, or when TG/WC and BP coexisted. However, no significant interactions were found between BP , WC , and TG. Conclusions: BP , WC, and TG were independent risk factors for CVD in Kazakhs. In clinical practice, a more informative assessment may be obtained by taking into account the number of MS components.

scholarly journals Early and Midterm Outcome of TEVAR for Thoracic Aortic Pseudoaneurysm

2021 ◽  
Author(s):  
Hui Wang ◽  
Tun Wang ◽  
Hao He ◽  
Xin Li ◽  
Yuan Peng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Cardiac Disease ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Aortic Pseudoaneurysm ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
The Mean

Abstract Backgrounds: The prognosis of thoracic aortic pseudoaneurysm (TAP) after thoracic endovascular aortic repair (TEVAR) remains unclear. This study investigates the early and midterm clinical outcome as well as relevant risk factors of TAP patients following TEVAR therapy.Methods: From July 2010 to July 2020, 37 eligible TAP patients who underwent TEVAR were selected into our research. We retrospectively explored their baseline, perioperative and follow-up data. Fisher exact test and Kaplan-Meier method were applied for comparing difference between groups. Risk factors of late survival were discerned using Cox regression analysis.Results: There were 29 men and 12 women, with the mean age as 59.5±13.0 years (range, 30-82). The mean follow-up time was 30.7±28.3 months (range, 1-89). For early result, early mortality (≦30days) happened in 3(8.1%) zone 3 TAP patients versus 0 in zone 4 (p= 0.028); acute arterial embolism of lower extremity and type II endoleak respectively occurred in 1(2.7%) case. For midterm result, survival at 3 months, 1 year and 5 years was 88.8±5.3%, 75.9±7.5% and 68.3±9.9%, which showed significant difference between zone 2/3 versus zone 4 group (56.3±14.8% versus 72.9±13.2%, p= 0.013) and emergent versus elective TEVAR groups (0.0±0.0% versus 80.1±8.0%, p= 0.049). On multivariate Cox regression, lesions at zone 2/3 (HR 4.605, 95%CI 1.095-19.359), concomitant cardiac disease (HR 4.932, 95%CI 1.086-22.403) and emergent TEVAR (HR 4.196, 95%CI 1.042-16.891) were significant independent risk factors for worse late clinical outcome. Conclusions: TEVAR therapy is effective and safe with satisfactory early and midterm clinical outcome for TAP patients. Lesions at zone 2/3, concomitant cardiac disease and emergent TEVAR were independent risk factors for midterm survival outcome.

scholarly journals Cox Regression Analysis of 1739 Emergency Trauma Patients

2020 ◽  
Author(s):  
Jun Shen ◽  
Feng Xu ◽  
Du Chen
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Oxygen Saturation ◽  
Cox Regression ◽  
Trauma Patients ◽  
Term Survival ◽  
Cox Regression Analysis ◽  
Revised Trauma Score ◽  
Independent Risk Factors ◽  
Trauma Score

Abstract BACKGROUND: Trauma is a damage caused by physical harm from external source. It has been one of the major causes of mortality. The purpose of this study was to explore the risk factors related to mortality among emergency trauma patients. METHODS: This was a retrospective study in trauma center of the First Affiliated Hospital of Soochow University. The data were obtained from trauma database with patients registered from November 1, 2016 to November 30, 2019.Shapiro–Wilk test, Mann-Whitney test and Likelihood-ratio Chi squared test were used to assess the survival pattern. Cox regressions were performed to calculate the hazard ratios (HRs) of variables for death. RESULTS: The total 1739 emergency trauma patients, 44 (2.53%) died during the study period and 1695 (97.47%) were survival. Through univariable and multivariable Cox regression analysis, three independent risk factors for emergency death were screened out: pulse (Crude HR: 0.97, 95% Confidence Interval [CI]: 0.96-0.98; Adjuste HR: 1.04, 95% CI: 1.02-1.06), pulse oxygen saturation (Crude HR: 0.96, 95% CI: 0.95-0.97; Adjuste HR: 0.94, 95% CI: 0.91-0.97) and Revised Trauma Score (Crude HR: 0.69, 95% CI: 0.65-0.74; Adjuste HR: 0.79, 95% CI: 0.64-0.97).CONCLUSION: The survival outcome of emergency trauma patients was influenced by many factors. Pulse, pulse oxygen saturation (SpO2 ) and Revised Trauma Score (RTS) were the independent risk factors for mortality. Accurate analysis and judgment of the risk factors can improve cure efficiency and long-term survival rate.

scholarly journals Identification of Core Genes Related to Progression and Prognosis of Hepatocellular Carcinoma and Small-Molecule Drug Predication

2021 ◽  
Vol 12 ◽  
Author(s):  
Nan Jiang ◽  
Xinzhuo Zhang ◽  
Dalian Qin ◽  
Jing Yang ◽  
Anguo Wu ◽  
...  
Keyword(s):  
Gene Expression ◽  
Hepatocellular Carcinoma ◽  
Cell Cycle ◽  
Small Molecule ◽  
Molecular Mechanisms ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Gene Expression Signature ◽  
Cox Regression Analysis ◽  
Small Molecule Drugs

BackgroundHepatocellular carcinoma (HCC) is one of the most leading causes of cancer death with a poor prognosis. However, the underlying molecular mechanisms are largely unclear, and effective treatment for it is limited. Using an integrated bioinformatics method, the present study aimed to identify the key candidate prognostic genes that are involved in HCC development and identify small-molecule drugs with treatment potential.Methods and ResultsIn this study, by using three expression profile datasets from Gene Expression Omnibus database, 1,704 differentially expressed genes were identified, including 671 upregulated and 1,033 downregulated genes. Then, weighted co-expression network analysis revealed nine modules are related with pathological stage; turquoise module was the most associated module. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway analyses (KEGG) indicated that these genes were enriched in cell division, cell cycle, and metabolic related pathways. Furthermore, by analyzing the turquoise module, 22 genes were identified as hub genes. Based on HCC data from gene expression profiling interactive analysis (GEPIA) database, nine genes associated with progression and prognosis of HCC were screened, including ANLN, BIRC5, BUB1B, CDC20, CDCA5, CDK1, NCAPG, NEK2, and TOP2A. According to the Human Protein Atlas and the Oncomine database, these genes were highly upregulated in HCC tumor samples. Moreover, multivariate Cox regression analysis showed that the risk score based on the gene expression signature of these nine genes was an independent prognostic factor for overall survival and disease-free survival in HCC patients. In addition, the candidate small-molecule drugs for HCC were identified by the CMap database.ConclusionIn conclusion, the nine key gene signatures related to HCC progression and prognosis were identified and validated. The cell cycle pathway was the core pathway enriched with these key genes. Moreover, several candidate molecule drugs were identified, providing insights into novel therapeutic approaches for HCC.

Effect of bronchial artery embolisation on the management of tuberculosis-related haemoptysis

2019 ◽  
Vol 23 (12) ◽  
pp. 1269-1276
Author(s):  
Y. Peng ◽  
Y. Zhu ◽  
G. Ao ◽  
Z. Chen ◽  
X. Yuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cox Regression ◽  
Bronchial Artery ◽  
Cox Regression Analysis ◽  
Pleural Thickening ◽  
Factors Influencing ◽  
Arterial Embolisation ◽  
Independent Risk Factors ◽  
Bronchial Artery Embolisation

OBJECTIVE: To identify risk factors influencing outcomes of bronchial arterial embolisation (BAE) in tuberculosis (TB) related haemoptysis.METHODS: A cohort of 207 patients underwent BAE for TB-related haemoptysis between March 2014 and March 2018. The clinical data were reviewed. Follow-up ranged from 24 to 1749 days.RESULTS: Immediate haemostasis rate was 94.2%; aggressive pleural thickening (PT) was found to be a risk factor for haemoptysis (P = 0.000, OR 22.52). Cumulative recurrence-free rates were respectively 98.5%, 94.8%, 88.7%, 79.9%, 68.5%, 65.7% and 62.7% for 1, 3, 6, 12, 24, 36 and 48 months. Respectively 8 and 15 patients recovered from pneumonectomy and re-BAE. However, five patients required a third BAE. The Cox regression analysis indicated that aggressive PT (P = 0.000), diabetes mellitus (DM) (P = 0.018) and pulmonary fungal infection (PFI) (P = 0.001) were independent risk factors for recurrence. The death rate following BAE was 9.2%; aggressive PT was a risk factor (P = 0.000, OR 8.14).CONCLUSION: BAE is effective for TB-related haemoptysis in most cases. Aggressive PT, DM and PFI are independent risk factors influencing the prognosis following BAE. PFI and DM should be well managed, while proper surgery should be considered for aggressive PT.

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