AIM:To investigate primarily the prognostic value of Ki-67,as well as other parameters,in gastrointestinal stromal tumors(GISTs).METHODS:Ki-67,c-KIT,platelet-derived growth factor receptor-alpha(PDGFRα),smooth muscle...AIM:To investigate primarily the prognostic value of Ki-67,as well as other parameters,in gastrointestinal stromal tumors(GISTs).METHODS:Ki-67,c-KIT,platelet-derived growth factor receptor-alpha(PDGFRα),smooth muscle actin(SMA),CD34,S100 were stained for immunohistochemistry which was performed on formalin-fixed,paraffinembeded sections on representative block from each case.Proliferation index counted by Ki-67 antibody was calculated as a number of positive nuclear reaction over 100 cells.Immunoreactivity for c-KIT and PDGFRα was evaluated semiquantitatively(weak,intermediate,strong) and for c-KIT type of reactivity was analyzed(cytoplasmic,membrane and "dot-like" staining).Immunoreactivity for SMA,CD34 and S100 were was evaluated as positive or negative antigen expression.Pathologic parameters investigated in this study included tumor size,cell type(pure spindle,pured epitheloid mixed spindle and epitheloid),mitotic count,hemorrhage,necrosis,mucosal ulceration.Clinical data included age,gender,primary tumor location and spread of disease.χ 2 test and Student's t-test were used for comparisons of baseline characteristics.The Cox's proportional hazard model was used for univariable and multivariable analyses.Survival rates were calculated by Kaplan-Meier method and statistical significance was determined by the log-rank test.RESULTS:According to the stage of disease,there were 36 patients with localized disease,29 patients with initially localized disease but with its recurrence in the period of follow up,and finally,35 patients had metastatic disease from the very beginning of disease.Tumor originated most commonly in the stomach(41%),small intestine was the second most common location(36%).The mean size of primary tumors was 6.5 cm.The mean duration of follow-up was 60 mo.Multiple parameters were analyzed for their effect on overall survival,but no one reached statistical significance(P = 0.06).Analysis of time to progression/relapse in initially localized disease(univariate analysis),tumor size,mitotic count,Ki-67 and type of d-KIT distribution(cytoplasmic vs membrane/"dot-like") showed statistically significant correlation.In multivariate analysis in the group of patients with localized disease,there were only 2 parameters that have impact on relapse,Ki-67 and SMA(P < 0.0001 and P < 0.034,respectively).Furthermore,Ki-67 was analyzed in localized diseasevs localized with recurrence and metastatic disease.It was shown that there is a strict difference between these 2 groups of patients(median value was 2.5 for localized disease vs 10.0 for recurrent/metastatic disease,P < 0.0001).It was also shown that the cut-off value which is still statistically significant in terms of relapse on the level of 6%.The curves for survival on that cut-off level are significantly different(P < 0.04,Cox F).CONCLUSION:Ki-67 presents a significant prognostic factor for GIST recurrence which could be of great importance in evaluating malignant potential of disease.展开更多
Objective: The biennial epidemic pattern of respiratory syncytial virus (RSV) circulation in Croatia has been preserved and could not be related to climatic factors and the predominant RSV subtypes. The possibility th...Objective: The biennial epidemic pattern of respiratory syncytial virus (RSV) circulation in Croatia has been preserved and could not be related to climatic factors and the predominant RSV subtypes. The possibility that the circulation of different RSV genotypes affect the outbreak cycle in children in Croatia (Zagreb region) over a period of 3 consecutive years was explored in the paper. Methods: The study group consisted of inpatients, aged 0-10 years, who were hospi- talized with acute respiratory tract infections caused by RSV, in Zagreb, over the period from 1 January 2006 to 31 De- cember 2008. The virus was identified in the nasopharyngeal secretion using direct immunofluorescence method. The virus subtype and genotype was determined by real-time PCR and sequence analysis, respectively. Results: RSV infec- tions identified in 731 children. RSV subtype A caused 399 infections, and subtype B 332. Two subtype A genotypes (NA1 and GA5) and three subtype B genotypes (BA7, BA9 and BA10) were found. During persistent RSV biennial cycles namely four succeeding outbreaks, the new genotype from the previous smaller outbreak persevered into the up- coming larger outbreak. Conclusion: Our molecular-epidemiology study of RSV subtypes and genotypes during calen- dar months demonstrates that the biennial RSV cycle cannot be fully explained by the dynamic of the predominant cir- culating genotype of RSV. Other unknown factors account for the biennial cycle of RSV epidemics in Croatia.).展开更多
文摘AIM:To investigate primarily the prognostic value of Ki-67,as well as other parameters,in gastrointestinal stromal tumors(GISTs).METHODS:Ki-67,c-KIT,platelet-derived growth factor receptor-alpha(PDGFRα),smooth muscle actin(SMA),CD34,S100 were stained for immunohistochemistry which was performed on formalin-fixed,paraffinembeded sections on representative block from each case.Proliferation index counted by Ki-67 antibody was calculated as a number of positive nuclear reaction over 100 cells.Immunoreactivity for c-KIT and PDGFRα was evaluated semiquantitatively(weak,intermediate,strong) and for c-KIT type of reactivity was analyzed(cytoplasmic,membrane and "dot-like" staining).Immunoreactivity for SMA,CD34 and S100 were was evaluated as positive or negative antigen expression.Pathologic parameters investigated in this study included tumor size,cell type(pure spindle,pured epitheloid mixed spindle and epitheloid),mitotic count,hemorrhage,necrosis,mucosal ulceration.Clinical data included age,gender,primary tumor location and spread of disease.χ 2 test and Student's t-test were used for comparisons of baseline characteristics.The Cox's proportional hazard model was used for univariable and multivariable analyses.Survival rates were calculated by Kaplan-Meier method and statistical significance was determined by the log-rank test.RESULTS:According to the stage of disease,there were 36 patients with localized disease,29 patients with initially localized disease but with its recurrence in the period of follow up,and finally,35 patients had metastatic disease from the very beginning of disease.Tumor originated most commonly in the stomach(41%),small intestine was the second most common location(36%).The mean size of primary tumors was 6.5 cm.The mean duration of follow-up was 60 mo.Multiple parameters were analyzed for their effect on overall survival,but no one reached statistical significance(P = 0.06).Analysis of time to progression/relapse in initially localized disease(univariate analysis),tumor size,mitotic count,Ki-67 and type of d-KIT distribution(cytoplasmic vs membrane/"dot-like") showed statistically significant correlation.In multivariate analysis in the group of patients with localized disease,there were only 2 parameters that have impact on relapse,Ki-67 and SMA(P < 0.0001 and P < 0.034,respectively).Furthermore,Ki-67 was analyzed in localized diseasevs localized with recurrence and metastatic disease.It was shown that there is a strict difference between these 2 groups of patients(median value was 2.5 for localized disease vs 10.0 for recurrent/metastatic disease,P < 0.0001).It was also shown that the cut-off value which is still statistically significant in terms of relapse on the level of 6%.The curves for survival on that cut-off level are significantly different(P < 0.04,Cox F).CONCLUSION:Ki-67 presents a significant prognostic factor for GIST recurrence which could be of great importance in evaluating malignant potential of disease.
文摘Objective: The biennial epidemic pattern of respiratory syncytial virus (RSV) circulation in Croatia has been preserved and could not be related to climatic factors and the predominant RSV subtypes. The possibility that the circulation of different RSV genotypes affect the outbreak cycle in children in Croatia (Zagreb region) over a period of 3 consecutive years was explored in the paper. Methods: The study group consisted of inpatients, aged 0-10 years, who were hospi- talized with acute respiratory tract infections caused by RSV, in Zagreb, over the period from 1 January 2006 to 31 De- cember 2008. The virus was identified in the nasopharyngeal secretion using direct immunofluorescence method. The virus subtype and genotype was determined by real-time PCR and sequence analysis, respectively. Results: RSV infec- tions identified in 731 children. RSV subtype A caused 399 infections, and subtype B 332. Two subtype A genotypes (NA1 and GA5) and three subtype B genotypes (BA7, BA9 and BA10) were found. During persistent RSV biennial cycles namely four succeeding outbreaks, the new genotype from the previous smaller outbreak persevered into the up- coming larger outbreak. Conclusion: Our molecular-epidemiology study of RSV subtypes and genotypes during calen- dar months demonstrates that the biennial RSV cycle cannot be fully explained by the dynamic of the predominant cir- culating genotype of RSV. Other unknown factors account for the biennial cycle of RSV epidemics in Croatia.).
