AIM： To investigate the prognostic value of the model for end-stage liver disease （MELD） and three new MELD-based models combination with serum sodium in decompensated cirrhosis patients-the MELD with the incorpora...AIM： To investigate the prognostic value of the model for end-stage liver disease （MELD） and three new MELD-based models combination with serum sodium in decompensated cirrhosis patients-the MELD with the incorporation of serum sodium （MELD-Na）, the integrated MELD （iMELD）, and the MELD to sodium （MESO） index. METHODS： A total of 166 patients with decompensated cirrhosis were enrolled into the study. MELD, MELD- Na, iMELD and MESO scores were calculated for each patient following the original formula on the first day of admission. All patients were followed up at least 1 year. The predictive prognosis related with the four models was determined by the area under the receiver operating characteristic curve （AUC） of the four parameters. Kaplan-Meier survival curves were made using the cut-offs identified by means of receiver operating characteristic （ROC）. RESULTS： Out of 166 patients, 38 patients with significantly higher MELD-Na （28.84 ± 2.43 vs 14.72 ± 0.60）, iMELD （49.04 ± 1.72 vs 35.52 ± 0.67）, MESO scores （1.59 ± 0.82 vs 0.99 ± 0.42） compared to the survivors died within 3 mo （P 〈 0.001）. Of 166 patients, 75 with markedly higher MELD-Na （23.01 ± 1.51 vs 13.78 ± 0.69）, iMELD （44.06 ± 1.19 vs 34.12 ± 0.69）, MESO scores （1.37 ± 0.70 vs 0.93 ± 0.40） than the survivors died within 1 year （P 〈 0.001）. At 3 mo of enrollment, the iMELD had the highest AUC （0.841）, and was followed by the MELD-Na （0.766）, MESO （0.723）, all larger than MELD （0.773）; At year, the iMELD still had the highest AUC （0.783）, the difference between the iMELD and MELD was statistically significant （P 〈 0.05）. Survival curves showed that the three new models were all clearly discriminated the patients who survived or died in short-term as well as intermediate-term （P 〈 0.001）. CONCLUSION： Three new models, changed with serum sodium （MELD-Na, iMELD, MESO） can exactly predict the prognosis of patients with decompensated cirrhosis for short and intermediate period, and may enhance the prognostic accuracy of MELD. The iMELD is better prognostic model for outcome prediction in patients with decompensated cirrhosis.展开更多
AIM:To analyze the prognostic factors involved in survival and cancer recurrence in patients undergoing surgical treatment for colorectal liver metastases(CLM) and to describe the effects of time-related changes on su...AIM:To analyze the prognostic factors involved in survival and cancer recurrence in patients undergoing surgical treatment for colorectal liver metastases(CLM) and to describe the effects of time-related changes on survival and recurrence in these patients.METHODS:From January 1994 to January 2006,236 patients with CLM underwent surgery with the aim of performing curative resection of neoplastic disease at our institution and 189(80%) of these patients underwent resection of CLM with curative intention.Preoperative,intraoperative and postoperative data,including primary tumor and CLM pathology results,were retrospectively reviewed.Patients were divided into two time periods:a first period from January 1994 to January 2000(n = 93),and a second period from February 2000 to January 2006(n = 143).RESULTS:Global survival at 1,3 and 5 years in patients undergoing hepatic resection was 91%,54% and 47%,respectively.Patients with preoperative extrahepatic disease,carcinoembryonic antigen(CEA) levels over 20 ng/dL,more than four nodules or extrahepatic invasion at pathological analysis had worse survival.Tumor recurrence rate at 1 year was 48.3%,being more frequent in patients with preoperative and pathological extrahepatic disease and CEA levels over 20 ng/dL.Although patients in the second time period had more adverse prognostic factors,no differences in overall survival and recurrence were observed between the two periods.CONCLUSION:Despite advances in surgical technique and better adjuvant treatments and preoperative imaging,careful patient staging and selection is crucial to continue offering a chance of cure to patients with CLM.展开更多
Currently, some fault prognosis technology occasionally has relatively unsatisfied performance especially for in- cipient faults in nonlinear processes duo to their large time delay and complex internal connection. To...Currently, some fault prognosis technology occasionally has relatively unsatisfied performance especially for in- cipient faults in nonlinear processes duo to their large time delay and complex internal connection. To overcome this deficiency, multivariate time delay analysis is incorporated into the high sensitive local kernel principal component analysis. In this approach, mutual information estimation and Bayesian information criterion （BIC） are separately used to acquire the correlation degree and time delay of the process variables. Moreover, in order to achieve prediction, time series prediction by back propagation （BP） network is applied whose input is multivar- iate correlated time series other than the original time series. Then the multivariate time delayed series and future values obtained by time series prediction are combined to construct the input of local kernel principal component analysis （LKPCA） model for incipient fault prognosis. The new method has been exemplified in a sim- ple nonlinear process and the complicated Tennessee Eastman （TE） benchmark process. The results indicate that the new method has suoerioritv in the fault prognosis sensitivity over other traditional fault prognosis methods.展开更多
AIM:To understand the clinicopathological characteristics and treatment selections and improve survival and provide valuable information for patients with intrahepatic cholangiocarcinoma(ICC). METHODS:We retrospective...AIM:To understand the clinicopathological characteristics and treatment selections and improve survival and provide valuable information for patients with intrahepatic cholangiocarcinoma(ICC). METHODS:We retrospectively evaluated 5311 liver cancer patients who received resection between October 1999 and December 2003.Of these,429(8.1%)patients were diagnosed with ICC,and their clinicopathological, surgical,and survival characteristics were analyzed. RESULTS:Upper abdominal discomfort or pain(65.0%), no symptoms(12.1%),and hypodynamia(8.2%)were the major causes for medical attention.Laboratory tests showed 198(46.4%)patients were HBsAg positive, 90(21.3%)hadα-fetoprotein>20μg/L,50(11.9%) carcinoembryonic antigen>10μg/L,and 242(57.5%) carbohydrate antigen 19-9(CA19-9)>37 U/mL.Survival data was available for 329(76.7%)patients and their mean survival time was 12.4 mo.The overall survival of the patients with R0,R1 resection and punching exploration were 18.3,6.6 and 5.6 mo,respectively. Additionally,CA19-9>37 U/mL was associated with lymph node metastases,but inversely associated withcirrhosis.Multivariate analysis indicated that radical resection,lymph node metastases,macroscopic tumor thrombi and size,and CA19-9 were associated with prognosis. CONCLUSION:Surgical radical resection is still the most effective means to cure ICC.Certain laboratory tests(such as CA19-9)can effectively predict the survival of the patients with ICC.展开更多
Objective The aim of this study was to test whether carcinoembryonic antigen （CEA） and cytokeratin 19 fragments （CYFRA21-1） can be used as a prognostic factor for non-small-cell lung cancer （NSCLC） after two cyc...Objective The aim of this study was to test whether carcinoembryonic antigen （CEA） and cytokeratin 19 fragments （CYFRA21-1） can be used as a prognostic factor for non-small-cell lung cancer （NSCLC） after two cycles of adjuvant chemotherapy in NSCLC patients. Methods A total of 169 patients underwent at least two cycles of adjuvant chemotherapy. The serum levels of CEA and CYFRA21-1 were recorded after the second cycle of chemotherapy, and the patient follow-up was conducted. Overall survival （OS） and disease- free survival （DFS） were used as the primary endpoint and the secondary endpoint, respectively. Results The high levels of CEA and CYFRA21-1 after two cycles of adjuvant chemotherapy were poor prognostic factors for OS, with risk ratios （RR） of 2.003 and 1.702, respectively. A high CEA level was a poor prognostic factor （RR 1.152） for DFS. The median survival time （MST） of the high CEA level group was 26 months, whereas that of the normal group was 61 months （P〈0.0001）. The median DFS time of the high CEA group and the normal group was 34 and 53 months, respectively （P〈0.0001）. The MST of the high CYFRA21-1 group and the normal group was 43 and 56 months, respectively （P〈0.0001）. Conclusions The high serum levels of CEA or CYFRA21-1 after two cycles of adjuvant chemotherapy are poor prognostic factors for NSCLC patients.展开更多
AIM:To evaluate the clinical significance of oxidative stress markers in patients with hepatitis C virus(HCV)related hepatocellular carcinoma(HCC).METHODS:Sixty-four consecutive patients who were admitted to Kagoshima...AIM:To evaluate the clinical significance of oxidative stress markers in patients with hepatitis C virus(HCV)related hepatocellular carcinoma(HCC).METHODS:Sixty-four consecutive patients who were admitted to Kagoshima University Medical and Dental Hospital were enrolled in this retrospective study.All patients had chronic liver disease(CLD) due to infection with HCV.Thirty patients with HCV-related HCC,34 with HCV-related CLD without HCC(non-HCC),and 20 healthy volunteers(HVs) were enrolled.Possible associations between serum manganese superoxide dismutase(MnSOD) and thioredoxin(TRX) levels and clinical parameters or patient prognosis were analyzed over a mean follow-up period of 31.7 mo.RESULTS:The serum MnSOD levels were significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.03) or HVs(P < 0.001).Similarly,serum TRX levels were also significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.04) or HVs(P < 0.01).However,serum levels of MnSOD and TRX were not correlated in patients with HCC.Among patients with HCC,the overall survival rate(OSR) was lower in patients with MnSOD levels ≥ 110 ng/mL than in patients with levels < 110 ng/mL(P = 0.01),and the OSR tended to be lower in patients with TRX levels < 80 ng/mL(P = 0.05).In addition,patient prognosis with HCC was poorest with serum MnSOD levels ≥ 110 ng/mL and serum TRX levels < 80 ng/mL.Furthermore,a multivariate analysis using a Cox proportional hazard model and serum levels of five factors(MnSOD,prothrombin time,serum albumin,serum α-fetoprotein(AFP),and serum des-γ-carboxy prothrombin) revealed that MnSOD levels ≥ 110 ng/mL(risk ratio:4.12,95% confidential interval:1.22-13.88,P = 0.02) and AFP levels ≥ 40 ng/mL(risk ratio:6.75;95% confidential interval:1.70-26.85,P < 0.01) were independent risk factors associated with a poor patient prognosis.CONCLUSION:Serum MnSOD and TRX levels are potential clinical biomarkers that predict patient prognosis in HCV-related HCC.展开更多
Objective The aim of the study was to probe into the impacts of the times of preventive transcatheter arterial chemoembolization (TACE) after operation treatment for patients with primary liver cancer on their survival.
文摘AIM： To investigate the prognostic value of the model for end-stage liver disease （MELD） and three new MELD-based models combination with serum sodium in decompensated cirrhosis patients-the MELD with the incorporation of serum sodium （MELD-Na）, the integrated MELD （iMELD）, and the MELD to sodium （MESO） index. METHODS： A total of 166 patients with decompensated cirrhosis were enrolled into the study. MELD, MELD- Na, iMELD and MESO scores were calculated for each patient following the original formula on the first day of admission. All patients were followed up at least 1 year. The predictive prognosis related with the four models was determined by the area under the receiver operating characteristic curve （AUC） of the four parameters. Kaplan-Meier survival curves were made using the cut-offs identified by means of receiver operating characteristic （ROC）. RESULTS： Out of 166 patients, 38 patients with significantly higher MELD-Na （28.84 ± 2.43 vs 14.72 ± 0.60）, iMELD （49.04 ± 1.72 vs 35.52 ± 0.67）, MESO scores （1.59 ± 0.82 vs 0.99 ± 0.42） compared to the survivors died within 3 mo （P 〈 0.001）. Of 166 patients, 75 with markedly higher MELD-Na （23.01 ± 1.51 vs 13.78 ± 0.69）, iMELD （44.06 ± 1.19 vs 34.12 ± 0.69）, MESO scores （1.37 ± 0.70 vs 0.93 ± 0.40） than the survivors died within 1 year （P 〈 0.001）. At 3 mo of enrollment, the iMELD had the highest AUC （0.841）, and was followed by the MELD-Na （0.766）, MESO （0.723）, all larger than MELD （0.773）; At year, the iMELD still had the highest AUC （0.783）, the difference between the iMELD and MELD was statistically significant （P 〈 0.05）. Survival curves showed that the three new models were all clearly discriminated the patients who survived or died in short-term as well as intermediate-term （P 〈 0.001）. CONCLUSION： Three new models, changed with serum sodium （MELD-Na, iMELD, MESO） can exactly predict the prognosis of patients with decompensated cirrhosis for short and intermediate period, and may enhance the prognostic accuracy of MELD. The iMELD is better prognostic model for outcome prediction in patients with decompensated cirrhosis.
基金Supported by An investigation grant from Abertis Infraestructuras S.A
文摘AIM:To analyze the prognostic factors involved in survival and cancer recurrence in patients undergoing surgical treatment for colorectal liver metastases(CLM) and to describe the effects of time-related changes on survival and recurrence in these patients.METHODS:From January 1994 to January 2006,236 patients with CLM underwent surgery with the aim of performing curative resection of neoplastic disease at our institution and 189(80%) of these patients underwent resection of CLM with curative intention.Preoperative,intraoperative and postoperative data,including primary tumor and CLM pathology results,were retrospectively reviewed.Patients were divided into two time periods:a first period from January 1994 to January 2000(n = 93),and a second period from February 2000 to January 2006(n = 143).RESULTS:Global survival at 1,3 and 5 years in patients undergoing hepatic resection was 91%,54% and 47%,respectively.Patients with preoperative extrahepatic disease,carcinoembryonic antigen(CEA) levels over 20 ng/dL,more than four nodules or extrahepatic invasion at pathological analysis had worse survival.Tumor recurrence rate at 1 year was 48.3%,being more frequent in patients with preoperative and pathological extrahepatic disease and CEA levels over 20 ng/dL.Although patients in the second time period had more adverse prognostic factors,no differences in overall survival and recurrence were observed between the two periods.CONCLUSION:Despite advances in surgical technique and better adjuvant treatments and preoperative imaging,careful patient staging and selection is crucial to continue offering a chance of cure to patients with CLM.
基金Supported by the National Natural Science Foundation of China(61573051,61472021)the Natural Science Foundation of Beijing(4142039)+1 种基金Open Fund of the State Key Laboratory of Software Development Environment(SKLSDE-2015KF-01)Fundamental Research Funds for the Central Universities(PT1613-05)
文摘Currently, some fault prognosis technology occasionally has relatively unsatisfied performance especially for in- cipient faults in nonlinear processes duo to their large time delay and complex internal connection. To overcome this deficiency, multivariate time delay analysis is incorporated into the high sensitive local kernel principal component analysis. In this approach, mutual information estimation and Bayesian information criterion （BIC） are separately used to acquire the correlation degree and time delay of the process variables. Moreover, in order to achieve prediction, time series prediction by back propagation （BP） network is applied whose input is multivar- iate correlated time series other than the original time series. Then the multivariate time delayed series and future values obtained by time series prediction are combined to construct the input of local kernel principal component analysis （LKPCA） model for incipient fault prognosis. The new method has been exemplified in a sim- ple nonlinear process and the complicated Tennessee Eastman （TE） benchmark process. The results indicate that the new method has suoerioritv in the fault prognosis sensitivity over other traditional fault prognosis methods.
基金Supported by The Shanghai Natural Science Foundation,No.09ZR1401100
文摘AIM:To understand the clinicopathological characteristics and treatment selections and improve survival and provide valuable information for patients with intrahepatic cholangiocarcinoma(ICC). METHODS:We retrospectively evaluated 5311 liver cancer patients who received resection between October 1999 and December 2003.Of these,429(8.1%)patients were diagnosed with ICC,and their clinicopathological, surgical,and survival characteristics were analyzed. RESULTS:Upper abdominal discomfort or pain(65.0%), no symptoms(12.1%),and hypodynamia(8.2%)were the major causes for medical attention.Laboratory tests showed 198(46.4%)patients were HBsAg positive, 90(21.3%)hadα-fetoprotein>20μg/L,50(11.9%) carcinoembryonic antigen>10μg/L,and 242(57.5%) carbohydrate antigen 19-9(CA19-9)>37 U/mL.Survival data was available for 329(76.7%)patients and their mean survival time was 12.4 mo.The overall survival of the patients with R0,R1 resection and punching exploration were 18.3,6.6 and 5.6 mo,respectively. Additionally,CA19-9>37 U/mL was associated with lymph node metastases,but inversely associated withcirrhosis.Multivariate analysis indicated that radical resection,lymph node metastases,macroscopic tumor thrombi and size,and CA19-9 were associated with prognosis. CONCLUSION:Surgical radical resection is still the most effective means to cure ICC.Certain laboratory tests(such as CA19-9)can effectively predict the survival of the patients with ICC.
文摘Objective The aim of this study was to test whether carcinoembryonic antigen （CEA） and cytokeratin 19 fragments （CYFRA21-1） can be used as a prognostic factor for non-small-cell lung cancer （NSCLC） after two cycles of adjuvant chemotherapy in NSCLC patients. Methods A total of 169 patients underwent at least two cycles of adjuvant chemotherapy. The serum levels of CEA and CYFRA21-1 were recorded after the second cycle of chemotherapy, and the patient follow-up was conducted. Overall survival （OS） and disease- free survival （DFS） were used as the primary endpoint and the secondary endpoint, respectively. Results The high levels of CEA and CYFRA21-1 after two cycles of adjuvant chemotherapy were poor prognostic factors for OS, with risk ratios （RR） of 2.003 and 1.702, respectively. A high CEA level was a poor prognostic factor （RR 1.152） for DFS. The median survival time （MST） of the high CEA level group was 26 months, whereas that of the normal group was 61 months （P〈0.0001）. The median DFS time of the high CEA group and the normal group was 34 and 53 months, respectively （P〈0.0001）. The MST of the high CYFRA21-1 group and the normal group was 43 and 56 months, respectively （P〈0.0001）. Conclusions The high serum levels of CEA or CYFRA21-1 after two cycles of adjuvant chemotherapy are poor prognostic factors for NSCLC patients.
基金Supported by (in part) Grants from the Ministry of Education,Culture, Sports, Science and Technology of Japan, and the Ministry of Health, Labour and Welfare of Japan
文摘AIM:To evaluate the clinical significance of oxidative stress markers in patients with hepatitis C virus(HCV)related hepatocellular carcinoma(HCC).METHODS:Sixty-four consecutive patients who were admitted to Kagoshima University Medical and Dental Hospital were enrolled in this retrospective study.All patients had chronic liver disease(CLD) due to infection with HCV.Thirty patients with HCV-related HCC,34 with HCV-related CLD without HCC(non-HCC),and 20 healthy volunteers(HVs) were enrolled.Possible associations between serum manganese superoxide dismutase(MnSOD) and thioredoxin(TRX) levels and clinical parameters or patient prognosis were analyzed over a mean follow-up period of 31.7 mo.RESULTS:The serum MnSOD levels were significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.03) or HVs(P < 0.001).Similarly,serum TRX levels were also significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.04) or HVs(P < 0.01).However,serum levels of MnSOD and TRX were not correlated in patients with HCC.Among patients with HCC,the overall survival rate(OSR) was lower in patients with MnSOD levels ≥ 110 ng/mL than in patients with levels < 110 ng/mL(P = 0.01),and the OSR tended to be lower in patients with TRX levels < 80 ng/mL(P = 0.05).In addition,patient prognosis with HCC was poorest with serum MnSOD levels ≥ 110 ng/mL and serum TRX levels < 80 ng/mL.Furthermore,a multivariate analysis using a Cox proportional hazard model and serum levels of five factors(MnSOD,prothrombin time,serum albumin,serum α-fetoprotein(AFP),and serum des-γ-carboxy prothrombin) revealed that MnSOD levels ≥ 110 ng/mL(risk ratio:4.12,95% confidential interval:1.22-13.88,P = 0.02) and AFP levels ≥ 40 ng/mL(risk ratio:6.75;95% confidential interval:1.70-26.85,P < 0.01) were independent risk factors associated with a poor patient prognosis.CONCLUSION:Serum MnSOD and TRX levels are potential clinical biomarkers that predict patient prognosis in HCV-related HCC.
文摘Objective The aim of the study was to probe into the impacts of the times of preventive transcatheter arterial chemoembolization (TACE) after operation treatment for patients with primary liver cancer on their survival.
