AIM:To understand the clinicopathological and prognostic features of gastric cancer in younger and older patients.METHODS:Between January 2002 and December2008,1667 patients underwent curative gastric surgery.For comp...AIM:To understand the clinicopathological and prognostic features of gastric cancer in younger and older patients.METHODS:Between January 2002 and December2008,1667 patients underwent curative gastric surgery.For comparative purposes,the patients were divided into two groups:younger patients who were less than 40 years old(112 patients),and older patients who were 40 years old and older(1555 patients).In both groups,propensity scoring methods were used to select patients with similar disease statuses.A total of224 matched cases,with 112 patients in each group,were included in the final analysis.RESULTS:Compared to the older group,the younger group with gastric cancer had a significantly higher percentage of females(P=0.007),poorly differentiated or signet ring cell carcinoma(P<0.001),advanced T stage gastric cancer(P=0.045),and advanced tumornode-metastasis stage cancer(P=0.036).The older group with gastric cancer had more comorbidities(P<0.001).With the exception of the number of lymph node dissection(P<0.001)and retrieved lymph node(P=0.010),there were no statistically significant differences between the postoperative outcomes of the two groups.During the follow-up period,there were19 recurrences in the younger group and 11 recurrences in the older group.The overall five-year survival rates in the younger and older groups were 84.3%and89.6%,respectively(P=0.172).There were no significant differences(P=0.238)in the overall survival of patients with advanced T stage gastric cancer in the two groups,with five-year survival rates of 70.8%in the younger group and 79.5%in the older group.With regard to the age-adjusted survival rate,there was significant difference between the two groups(P=0.225).CONCLUSION:In spite of aggressive cancer patterns in the younger group with gastric cancer,the younger group did not have a worse prognosis than the older group in our study.展开更多
BACKGROUND The impact of racial and regional disparity on younger patients with gastric cancer(GC) remains unclear.AIM To investigate the clinicopathological characteristics, prognostic nomogram, and biological analys...BACKGROUND The impact of racial and regional disparity on younger patients with gastric cancer(GC) remains unclear.AIM To investigate the clinicopathological characteristics, prognostic nomogram, and biological analysis of younger GC patients in China and the United States.METHODS From 2000 to 2018, GC patients aged less than 40 years were enrolled from the China National Cancer Center and the Surveillance Epidemiology and End Results database. Biological analysis was performed based on the Gene Expression Omnibus database. Survival analysis was conducted via Kaplan-Meier estimates and Cox proportional hazards models.RESULTS A total of 6098 younger GC patients were selected from 2000 to 2018, of which 1159 were enrolled in the China National Cancer Center, and 4939 were collected from the Surveillance Epidemiology and End Results database. Compared with the United States group, younger patients in China revealed better survival outcomes(P < 0.01). For race/ethnicity, younger Chinese cases also enjoyed a better prognosis than that in White and Black datasets(P < 0.01). After stratification by pathological Tumor-Node-Metastasis(pTNM) stage, a survival advantage was observed in China with pathological stage Ⅰ, Ⅲ, and Ⅳ(all P < 0.01), whereas younger GC patients with stage Ⅱ showed no difference(P = 0.16). In multivariate analysis, predictors in China involved period of diagnosis, linitis plastica, and pTNM stage, while race, diagnostic period, sex, location, differentiation, linitis plastica, signet ring cell, pTNM stage, surgery, and chemotherapy were confirmed in the United States group. Prognostic nomograms for younger patients were established, with the area under the curve of 0.786 in the China group and of 0.842 in the United States group. Moreover, three gene expression profiles(GSE27342, GSE51105, and GSE38749) were enrolled in further biological analysis, and distinctive molecular characteristics were identified in younger GC patients among different regions.CONCLUSION Except for younger cases with pTNM stage Ⅱ, a survival advantage was observed in the China group with pathological stage Ⅰ, Ⅲ, and Ⅳ compared to the United States group, which might be partly due to differences in surgical approaches and the improvement of the cancer screening in China. The nomogram model provided an insightful and applicable tool to evaluate the prognosis of younger patients in China and the United States. Furthermore, biological analysis of younger patients was performed among different regions, which might partly explain the histopathological behavior and survival disparity in the subpopulations.展开更多
Brain stroke in patients younger than 40 deprivessociety of its work force. Paradoxical brain embolism（PBE） is sometimes responsible. PBE should never beoverlooked in emergency settings because its recurrencemay be ...Brain stroke in patients younger than 40 deprivessociety of its work force. Paradoxical brain embolism（PBE） is sometimes responsible. PBE should never beoverlooked in emergency settings because its recurrencemay be preventable.展开更多
美国阴道镜和宫颈病理学会(American Society of Colposcopy and Cervical Pathology,ASCCP)于2020年4月发布了《基于风险的子宫颈癌筛查结果异常和癌前病变管理指南(2019年版)》(以下简称ASCCP-2019年指南)^([1])。该指南与之前版本的...美国阴道镜和宫颈病理学会(American Society of Colposcopy and Cervical Pathology,ASCCP)于2020年4月发布了《基于风险的子宫颈癌筛查结果异常和癌前病变管理指南(2019年版)》(以下简称ASCCP-2019年指南)^([1])。该指南与之前版本的关键区别在于其从基于筛查结果转变为基于风险值的精细化和个性化管理策略。进行风险评估的主要依据源自于美国北加州凯撒医疗机构(Kaiser Permanente Northern California,KPNC)的一项前瞻性纵向队列研究^([2]),该研究对150多万例25~65岁妇女进行了为期10年以上的随访,详细描述了各种风险指标的处理,但不适用于25岁以下患者。展开更多
目的探讨采用第3代陶对陶（ceramic-on-ceramic,CoC）假体行人工全髋关节置换术（total hip arthroplasty,THA）治疗中青年髋关节疾病的中远期疗效。方法回顾分析2001年3月-2009年5月收治并符合选择标准的68例73髋采用第3代CoC假体行TH...目的探讨采用第3代陶对陶（ceramic-on-ceramic,CoC）假体行人工全髋关节置换术（total hip arthroplasty,THA）治疗中青年髋关节疾病的中远期疗效。方法回顾分析2001年3月-2009年5月收治并符合选择标准的68例73髋采用第3代CoC假体行THA的中青年髋关节疾病患者临床资料。其中男39例,女29例;年龄18～50岁,平均38.6岁。股骨头缺血性坏死15例15髋,先天性髋关节发育不良9例9髋,强直性脊柱炎5例8髋,骨关节炎10例10髋,创伤性关节炎12例12髋,股骨颈骨折12例12髋,类风湿性关节炎4例6髋,股骨颈部肿瘤1例1髋。采用Harris评分及美国加州大学洛杉矶分校（UCLA）评分评估患者髋关节功能和活动水平,疼痛视觉模拟评分（VAS）评估术后大腿痛。影像学检查评估骨溶解、假体松动、陶瓷假体碎裂等相关并发症,并采用Kaplan-Meier生存分析评估假体生存情况。结果 68例患者均获随访,随访时间6～14年,平均9.7年。3例3髋采用＂三明治＂陶瓷内衬者出现内衬碎裂,行翻修术。1例1髋于术后3年重体力活动后出现髋关节异响,停止活动后异响消失。末次随访时患者Harris评分、UCLA评分均较术前显著改善（P〈0.05）。无大腿痛出现,VAS评分为0分。患者均获骨性固定,未出现骨溶解、假体松动及下沉等并发症。以陶瓷假体碎裂引起的翻修为终点,5年和10年累积生存率分别为98.6%及95.9%;以假体松动引起的翻修为终点,5年和10年累积生存率均为100%。结论第3代CoC假体可满足中青年患者THA的需要,中远期疗效满意。展开更多
基金Supported by The Dong-A University Research Fund
文摘AIM:To understand the clinicopathological and prognostic features of gastric cancer in younger and older patients.METHODS:Between January 2002 and December2008,1667 patients underwent curative gastric surgery.For comparative purposes,the patients were divided into two groups:younger patients who were less than 40 years old(112 patients),and older patients who were 40 years old and older(1555 patients).In both groups,propensity scoring methods were used to select patients with similar disease statuses.A total of224 matched cases,with 112 patients in each group,were included in the final analysis.RESULTS:Compared to the older group,the younger group with gastric cancer had a significantly higher percentage of females(P=0.007),poorly differentiated or signet ring cell carcinoma(P<0.001),advanced T stage gastric cancer(P=0.045),and advanced tumornode-metastasis stage cancer(P=0.036).The older group with gastric cancer had more comorbidities(P<0.001).With the exception of the number of lymph node dissection(P<0.001)and retrieved lymph node(P=0.010),there were no statistically significant differences between the postoperative outcomes of the two groups.During the follow-up period,there were19 recurrences in the younger group and 11 recurrences in the older group.The overall five-year survival rates in the younger and older groups were 84.3%and89.6%,respectively(P=0.172).There were no significant differences(P=0.238)in the overall survival of patients with advanced T stage gastric cancer in the two groups,with five-year survival rates of 70.8%in the younger group and 79.5%in the older group.With regard to the age-adjusted survival rate,there was significant difference between the two groups(P=0.225).CONCLUSION:In spite of aggressive cancer patterns in the younger group with gastric cancer,the younger group did not have a worse prognosis than the older group in our study.
基金National Key R&D Program of China,No.2017YFC0908300.
文摘BACKGROUND The impact of racial and regional disparity on younger patients with gastric cancer(GC) remains unclear.AIM To investigate the clinicopathological characteristics, prognostic nomogram, and biological analysis of younger GC patients in China and the United States.METHODS From 2000 to 2018, GC patients aged less than 40 years were enrolled from the China National Cancer Center and the Surveillance Epidemiology and End Results database. Biological analysis was performed based on the Gene Expression Omnibus database. Survival analysis was conducted via Kaplan-Meier estimates and Cox proportional hazards models.RESULTS A total of 6098 younger GC patients were selected from 2000 to 2018, of which 1159 were enrolled in the China National Cancer Center, and 4939 were collected from the Surveillance Epidemiology and End Results database. Compared with the United States group, younger patients in China revealed better survival outcomes(P < 0.01). For race/ethnicity, younger Chinese cases also enjoyed a better prognosis than that in White and Black datasets(P < 0.01). After stratification by pathological Tumor-Node-Metastasis(pTNM) stage, a survival advantage was observed in China with pathological stage Ⅰ, Ⅲ, and Ⅳ(all P < 0.01), whereas younger GC patients with stage Ⅱ showed no difference(P = 0.16). In multivariate analysis, predictors in China involved period of diagnosis, linitis plastica, and pTNM stage, while race, diagnostic period, sex, location, differentiation, linitis plastica, signet ring cell, pTNM stage, surgery, and chemotherapy were confirmed in the United States group. Prognostic nomograms for younger patients were established, with the area under the curve of 0.786 in the China group and of 0.842 in the United States group. Moreover, three gene expression profiles(GSE27342, GSE51105, and GSE38749) were enrolled in further biological analysis, and distinctive molecular characteristics were identified in younger GC patients among different regions.CONCLUSION Except for younger cases with pTNM stage Ⅱ, a survival advantage was observed in the China group with pathological stage Ⅰ, Ⅲ, and Ⅳ compared to the United States group, which might be partly due to differences in surgical approaches and the improvement of the cancer screening in China. The nomogram model provided an insightful and applicable tool to evaluate the prognosis of younger patients in China and the United States. Furthermore, biological analysis of younger patients was performed among different regions, which might partly explain the histopathological behavior and survival disparity in the subpopulations.
文摘Brain stroke in patients younger than 40 deprivessociety of its work force. Paradoxical brain embolism（PBE） is sometimes responsible. PBE should never beoverlooked in emergency settings because its recurrencemay be preventable.
文摘美国阴道镜和宫颈病理学会(American Society of Colposcopy and Cervical Pathology,ASCCP)于2020年4月发布了《基于风险的子宫颈癌筛查结果异常和癌前病变管理指南(2019年版)》(以下简称ASCCP-2019年指南)^([1])。该指南与之前版本的关键区别在于其从基于筛查结果转变为基于风险值的精细化和个性化管理策略。进行风险评估的主要依据源自于美国北加州凯撒医疗机构(Kaiser Permanente Northern California,KPNC)的一项前瞻性纵向队列研究^([2]),该研究对150多万例25~65岁妇女进行了为期10年以上的随访,详细描述了各种风险指标的处理,但不适用于25岁以下患者。
文摘目的探讨采用第3代陶对陶（ceramic-on-ceramic,CoC）假体行人工全髋关节置换术（total hip arthroplasty,THA）治疗中青年髋关节疾病的中远期疗效。方法回顾分析2001年3月-2009年5月收治并符合选择标准的68例73髋采用第3代CoC假体行THA的中青年髋关节疾病患者临床资料。其中男39例,女29例;年龄18～50岁,平均38.6岁。股骨头缺血性坏死15例15髋,先天性髋关节发育不良9例9髋,强直性脊柱炎5例8髋,骨关节炎10例10髋,创伤性关节炎12例12髋,股骨颈骨折12例12髋,类风湿性关节炎4例6髋,股骨颈部肿瘤1例1髋。采用Harris评分及美国加州大学洛杉矶分校（UCLA）评分评估患者髋关节功能和活动水平,疼痛视觉模拟评分（VAS）评估术后大腿痛。影像学检查评估骨溶解、假体松动、陶瓷假体碎裂等相关并发症,并采用Kaplan-Meier生存分析评估假体生存情况。结果 68例患者均获随访,随访时间6～14年,平均9.7年。3例3髋采用＂三明治＂陶瓷内衬者出现内衬碎裂,行翻修术。1例1髋于术后3年重体力活动后出现髋关节异响,停止活动后异响消失。末次随访时患者Harris评分、UCLA评分均较术前显著改善（P〈0.05）。无大腿痛出现,VAS评分为0分。患者均获骨性固定,未出现骨溶解、假体松动及下沉等并发症。以陶瓷假体碎裂引起的翻修为终点,5年和10年累积生存率分别为98.6%及95.9%;以假体松动引起的翻修为终点,5年和10年累积生存率均为100%。结论第3代CoC假体可满足中青年患者THA的需要,中远期疗效满意。
