Epidemiology and factors predicting survival of amyotrophic lateral sclerosis in a large Chinese cohort

Background:Amyotrophic lateral sclerosis(ALS)is a fatal neurodegenerative disorder associated with loss of motor neurons.Our objective was to explore the epidemiology,clinical features,and survival factors of 1809 patients with ALS.Methods:We analyzed 1809 ALS patients,who were recruited from the Peking University Third Hospital from January 2005 to December 2015.Demographic data and disease-related parameters were collected.Kaplan-Meier curves were used to compare survival time.Cox proportional hazards function and the hazard ratio were used to identify adjusted prognostic predictors.Results:The results showed that the average annual incidence in Beijing alone was 0.38 cases/100,000 person-years and the mean age of onset was 48.88±11.35(95%confidence interval[CI]:48.17–49.85)years.The median survival time from onset to death/tracheostomy was 58.89±33.03(95%CI:51.46–63.84)months.In the adjusted Cox proportional hazard model,age of onset,diagnosis delay,rate of disease progression(Amyotrophic Lateral Sclerosis Functional Rating Scale Revised decline[points/month]),and body mass index all had an independent effect on survival in ALS.Conclusions:Our study provides information on epidemiology,clinical features,and survival factors of patients with ALS in China.These results can be helpful in clinical practice,clinical trial design,and validation of new tools to predict disease progression.

A Meta-analysis Reveals Prognostic Role of Programmed Death Ligand-1 in Asian Patients with Non-small Cell Lung Cancer

Accumulating studies explored the clinicopathologic and prognostic value of programmed death ligand-1（PD-L1） in non-small cell lung cancer（NSCLC）, but the results were controversial. We therefore conducted a meta-analysis to evaluate the predictive role of PD-L1 in NSCLC patients. We systematically collected relevant studies from Pub Med, Embase, Web of Science and China National Knowledge Infrastructure. The pooled hazard ratios（HRs） with 95% confidence intervals（CIs） for overall survival（OS）, and odd ratios（ORs） with 95% CIs for clinicopathologic factors were calculated. A total of 15 studies involving 3605 patients were included in this meta-analysis. The results showed no prognostic role of PD-L1 in the whole patients（HR=1.60, 95% CI： 0.88–2.89, P=0.123）. Subgroup analysis showed that PD-L1 was associated with decreased OS in Asian patients（HR=2.00, 95% CI： 1.55–2.57, P〈0.001）. Among all the clinicopathologic factors, PD-L1 overexpression was significantly in relevance with poor tumor cell differentiation（HR=1.84, 95% CI： 1.49–2.28, P〈0.001）, late stage（HR=1.21, 95% CI： 1.02–1.43, P=0.026） and anaplastic lymphoma kinase（ALK） translocation（HR=2.63, 95% CI： 1.08–6.40, P=0.034）, but not with other factors. In conclusion, our meta-analysis demonstrated that PD-L1 has a prognostic role in Asian patients with NSCLC.