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Prognostic factors for poor recovery in acute whiplash patients  

Microsoft Academic Search

The objective of our prospective inception cohort study was to identify prognostic factors for poor recovery in patients with whiplash-associated disorders grade 1 or 2 who still had neck pain and accompanying complaints 2 weeks after the accident. The study was carried out in a primary health care setting in The Netherlands and included 125 patients. The primary outcome measure

Erik J. M. Hendriks; Gwendolijne G. M. Scholten-Peeters; Daniëlle A. W. M. van der Windt; Catharina W. M. Neeleman-van der Steen; Rob A. B. Oostendorp; Arianne P. Verhagen



Adjuvant Chemotherapy for Stage II Colon Cancer With Poor Prognostic Features  

PubMed Central

Purpose Adjuvant chemotherapy is typically considered for patients with stage II colon cancer characterized by poor prognostic features, including obstruction, perforation, emergent admission, T4 stage, resection of fewer than 12 lymph nodes, and poor histology. Despite frequent use, the survival advantage conferred on patients with stage II disease by chemotherapy is yet unproven. We sought to determine the overall survival benefit of chemotherapy among patients with stage II colon cancer having poor prognostic features. Patients and Methods A total of 43,032 Medicare beneficiaries who underwent colectomy for stage II and III primary colon adenocarcinoma diagnosed from 1992 to 2005 were identified from the Surveillance, Epidemiology, and End Results (SEER) –Medicare database. ?2 and two-way analysis of variance were used to assess differences in patient- and disease-related characteristics. Five-year overall survival was examined using Kaplan-Meier survival analysis and Cox proportional hazards regression with propensity score weighting. Results Of the 24,847 patients with stage II cancer, 75% had one or more poor prognostic features. Adjuvant chemotherapy was received by 20% of patients with stage II disease and 57% of patients with stage III disease. After adjustment, 5-year survival benefit from chemotherapy was observed only for patients with stage III disease (hazard ratio[HR], 0.64; 95% CI, 0.60 to 0.67). No survival benefit was observed for patients with stage II cancer with no poor prognostic features (HR, 1.02; 95% CI, 0.84 to 1.25) or stage II cancer with any poor prognostic features (HR, 1.03; 95% CI, 0.94 to 1.13). Conclusion Among Medicare patients identified with stage II colon cancer, either with or without poor prognostic features, adjuvant chemotherapy did not substantially improve overall survival. This lack of benefit must be considered in treatment decisions for similar older adults with colon cancer.

O'Connor, Erin S.; Greenblatt, David Yu; LoConte, Noelle K.; Gangnon, Ronald E.; Liou, Jinn-Ing; Heise, Charles P.; Smith, Maureen A.



Increased pretreatment levels of serum LDH and ALP as poor prognostic factors for nasopharyngeal carcinoma.  


Serum enzymes that play potential roles in tumor growth have recently been reported to have prognostic relevance in a diverse array of tumors. However, prognosis-related serum enzymes are rarely reported for nasopharyngeal carcinoma(NPC). To clarify whether the level of serum enzymes is linked to the prognosis of NPC, we reviewed the pretreatment data of lactate dehydrogenase(LDH), alkaline phosphatase (ALP), and glutamyl transferase (GGT) in 533 newly diagnosed NPC patients who underwent radical radiotherapy between May 2002 and October 2003 at Sun Yat-sen University Cancer Center. Patients were grouped according to the upper limit of normal values of LDH, ALP, and GGT. The Kaplan-Meier method and log-rank test were used for selecting prognostic factors from clinical characteristics and serum enzymes, and the chi-square test was applied to analyze the relationships of clinical characteristics and serum enzymes. Finally, a Cox proportional hazards model was used to identify the independent prognostic factors. We found that increased levels of LDH had poor effects on both overall survival and distant metastasis-free survival (P = 0.009 and 0.035, respectively), and increased pretreatment level of serum ALP had poor effects on both overall survival and local recurrence-free survival (P = 0.037 and 0.039, respectively). In multivariate analysis, increased LDH level was identified as an independent prognostic factor for overall survival. Therefore, we conclude that increased pretreatment serum LDH and ALP levels are poor prognostic factors for NPC. PMID:22237040

Li, Guo; Gao, Jin; Tao, Ya-Lan; Xu, Bing-Qing; Tu, Zi-Wei; Liu, Zhi-Gang; Zeng, Mu-Sheng; Xia, Yun-Fei



[Pulmonary sarcomatoid carcinoma: Clinical and prognostic characteristics, a case report].  


Sarcomatoid carcinoma is a rare malignancy in the family of non-small-cell lung cancer. They belong to a mixed group of poorly differenciated neoplasia, including sarcomatous cells or sarcomatoid-like cells with giant or spindle cells. We report the case of a 69-year-old man with sarcomatoid carcinoma. We describe the main characteristics of these tumors. Diagnosis is frequently delayed and lesions are locally advanced. The prognostic is poorer than other non-small-cell lung cancer. Chemotherapy is often not efficient. PMID:22197157

Paleiron, N; Tromeur, C; Gut-Gobert, C; André, N; Quiot, J-J; Quintin-Roué, I; Grassin, F; Mondine, P; Leroyer, C



Gene amplification is a poor prognostic factor in anaplastic oligodendrogliomas  

PubMed Central

Various gene amplifications have been observed in gliomas. Prognostic-genomic correlations testing simultaneously all these amplified genes have never been conducted in anaplastic oligodendrogliomas. A set of 38 genes that have been reported to be amplified in gliomas and investigated as the main targets of amplicons were studied in a series of 52 anaplastic oligodendrogliomas using bacterial artificial chromosome–array based comparative genomic hybridization and quantitative polymerase chain reaction. Among the 38 target genes, 15 were found to be amplified in at least one tumor. Overall, 27% of anaplastic oligodendrogliomas exhibited at least one gene amplification. The most frequently amplified genes were epidermal growth factor receptor (EGFR) and cyclin-dependent kinase 4/sarcoma amplified sequence (CDK4/SAS) in 17% and 8% of anaplastic oligodendrogliomas, respectively. Gene amplification and codeletion of chromosome arms 1p/19q were perfectly exclusive (p = 0.005). In uni- and multivariate analyses, gene amplification was a negative prognostic factor for progression-free survival and overall survival in anaplastic oligodendrogliomas, providing complementary information to the classic prognostic factors identified in anaplastic oligodendrogliomas (extent of surgery, KPS, and chromosome arms 1p/19q status).

Idbaih, Ahmed; Criniere, Emmanuelle; Marie, Yannick; Rousseau, Audrey; Mokhtari, Karima; Kujas, Michele; El Houfi, Younas; Carpentier, Catherine; Paris, Sophie; Boisselier, Blandine; Laigle-Donadey, Florence; Thillet, Joelle; Sanson, Marc; Hoang-Xuan, Khe; Delattre, Jean-Yves



Glycodelin A is a prognostic marker to predict poor outcome in advanced stage ovarian cancer patients  

PubMed Central

Background Glycodelin is a cell surface glycoprotein offering a unique gender specific carbohydrate configuration. Sialylated carbohydrate structures, which are unusual for mammals, characterize Glycodelin isolated from amniotic fluid (Glycodelin A, GdA). Glycodelin in general exerts multiple, partly opposing functions ranging from immunosuppression to cell differentiation. As these markedly influence tumorigenesis, this study aimed to clarify whether expression of different Glycodelin isoforms is related to clinicopathological characteristics and prognosis of ovarian cancer patients. Further the use of Glycodelin as a serum marker in benign and malignant ovarian diseases was evaluated. Methods Ovarian cancer specimens (n = 152) were stained for Glycodelin with carbohydrate and peptide specific antibodies. Associations between Glycodelin expression and histological grading, FIGO stage as well as patient’s prognosis were examined. Glycodelin was correlated to expression of gonadotropin receptors and mucin-1, which are discussed as ovarian cancer tissue markers. In addition, Glycodelin serum concentrations were analyzed in patients suffering from benign (n = 73) or malignant (n = 38) ovarian neoplasias. Results Glycodelin A was found to be an independent prognostic marker for poor prognosis in advanced ovarian cancer patients. GdA staining correlated with gonadotropin receptor (FSHR and LHCGR) and with hCG expression. Gd expression showed a positive correlation with a tumour-associated epitope of mucin 1 (TA-MUC1). Further, compared to ovarian cancer, serum Gd was increased in patients with benign ovarian tumors. Conclusion Glycodelin A might be related to tumor aggressiveness and poor clinical outcome in advanced epithelial ovarian cancer. Glycodelin serum levels found in patients suffering from benign ovarian tumors, might contribute to a more global attenuation during progression of these precursor lesions.



Baseline Diabetic Status and Admission Blood Glucose Were Poor Prognostic Factors in the EPITHET Trial  

Microsoft Academic Search

Background: Previous data have suggested that diabetes and hyperglycemia predict poor outcome following stroke. We studied the prognostic impact of diabetes and admission blood glucose in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET). Methods: EPITHET was a prospective randomized placebo-controlled trial of intravenous tissue plasminogen activator (tPA) in the 3- to 6-hour time window. A preexisting diagnosis of diabetes was

D. A. De Silva; M. Ebinger; S. Christensen; M. W. Parsons; C. Levi; K. Butcher; P. A. Barber; C. Bladin; G. A. Donnan; S. M. Davis



High GATA2 expression is a poor prognostic marker in pediatric acute myeloid leukemia.  


In acute myeloid leukemia (AML), aberrant expression and mutations of transcription factors have been correlated with disease outcome. In the present study, we performed expression and mutation screening of GATA2, which is an essential transcription factor for regulation of myeloid lineage determination, in de novo pediatric AML patients. GATA2 mutations were detected in 5 of 230 patients, representing a frequency of 2.2% overall and 9.8% in cytogenetically normal AML. GATA2 expression analysis demonstrated that in 155 of 237 diagnostic samples (65%), GATA2 expression was higher than in normal BM. In complete remission, normalization of GATA2 expression was observed, whereas GATA2 expression levels stayed high in patients with resistant disease. High GATA2 expression at diagnosis was an independent poor prognostic factor for overall survival (hazard ratio [HR] = 1.7, P = .045), event-free survival (HR = 2.1, P = .002), and disease-free survival (HR = 2.3, P = .004). The prognostic impact of GATA2 was particularly evident in specific AML subgroups. In patients with French-American-British M5 morphology, inv(16), or high WT1 expression, significant differences in survival were observed between patients with high versus normal GATA2 expression. We conclude that high GATA2 expression is a novel poor prognostic marker in pediatric AML, which may contribute to better risk-group stratification and risk-adapted therapy in the future. PMID:22786876

Luesink, Maaike; Hollink, Iris H I M; van der Velden, Vincent H J; Knops, Ruth H J N; Boezeman, Jan B M; de Haas, Valérie; Trka, Jan; Baruchel, Andre; Reinhardt, Dirk; van der Reijden, Bert A; van den Heuvel-Eibrink, Marry M; Zwaan, C Michel; Jansen, Joop H



High DNA Methyltransferase DNMT3B Levels: A Poor Prognostic Marker in Acute Myeloid Leukemia  

PubMed Central

It has been recently shown that DNA methyl transferase overexpression is correlated with unfavourable prognosis in human malignancies while methylation deregulation remains a hallmark that defines acute myeloid leukemia (AML). The oncogenic transcription factor EVI1 is involved in methylation deregulation and its overexpression plays a major role for predicting an adverse outcome. Moreover, the identification of DNMT3A mutations in AML patients has recently been described as a poor prognostic indicator. In order to clarify relationship between these key actors in methylation mechanisms and their potential impact on patient outcomes, we analysed 195 de novo AML patients for the expression of DNMT3A, 3B (and its non-catalytic variant 3BNC) and their correlations with the outcome and the expression of other common prognostic genetic biomarkers (EVI1, NPM1, FLT3ITD/TKD and MLL) in adult AML. The overexpression of DNMT3B/3BNC is (i) significantly correlated with a shorter overall survival, and (ii) inversely significantly correlated with event-free survival and DNMT3A expression level. Moreover, multivariate analysis showed that a high expression level of DNMT3B/3BNC is statistically a significant independent poor prognostic indicator. This study represents the first report showing that the overexpression of DNMT3B/3BNC is an independent predictor of poor survival in AML. Its quantification should be implemented to the genetic profile used to stratify patients for therapeutical strategies and should be useful to identify patients who may benefit from therapy based on demethylating agents.

Hayette, Sandrine; Thomas, Xavier; Jallades, Laurent; Chabane, Kaddour; Charlot, Carole; Tigaud, Isabelle; Gazzo, Sophie; Morisset, Stephane; Cornillet-Lefebvre, Pascale; Plesa, Adriana; Huet, Sarah; Renneville, Aline; Salles, Gilles; Nicolini, Franck Emmanuel; Magaud, Jean-Pierre; Michallet, Mauricette




PubMed Central

Background Despite better prognosis, there is a group of oropharyngeal squamous cell carcinoma (SCC) human papillomavirus (HPV)+ patients who experience treatment failure and succumb to distant metastasis. Methods Seventy-eight previously untreated patients nested in a concurrent chemoradiation protocol were reviewed to correlate patterns of local-regional tumor extent to distant metastasis. Biomarker assessment was: HPV in situ hybridization and epidermal growth factor receptor (EGFR) immunointensity. Results The 3-year disease-specific survival (DSS) for patients presenting with and without matted nodes was 69% and 94%, respectively (p = .003). Matted nodes were a poor prognostic factor independent of T classification, HPV, EGFR, and smoking status. For patients who were HPV+, 7 of 11 died of distant metastasis and 6 of 7 with distant metastasis had matted nodes. Conclusion Matted nodes are a novel marker of poor prognosis in oropharyngeal SCC independent of established prognostic factors. Matted nodes may identify patients at risk for the development of distant metastasis who could benefit from systemic therapy, whereas patients without matted nodes may be candidates for de-escalation of therapy.

Spector, Matthew E.; Gallagher, K. Kelly; Light, Emily; Ibrahim, Mohannad; Chanowski, Eric J.; Moyer, Jeffrey S.; Prince, Mark E.; Wolf, Gregory T.; Bradford, Carol R.; Cordell, Kitrina; McHugh, Jonathan B.; Carey, Thomas; Worden, Francis P.; Eisbruch, Avraham; Chepeha, Douglas B.



Decreased 5-hydroxymethylcytosine (5-hmC) is an independent poor prognostic factor in gastric cancer patients.  


DNA methylation at the 5 position of cytosine (5-mC) is a key epigenetic mark that is involved in various biological and pathological processes. 5-mC can be converted to 5-hydroxymethylcytosine (5-hmC) by the ten-eleven translocation (TET) family of DNA hydroxylases. Increasing evidence suggests that large-scale loss of 5-hmC is an epigenetic hallmark of several human cancers. However, the value of 5-hmC in diagnosis and prognosis of human cancers, including gastric cancer (GC), remains largely unknown. The aim of this study is to determine 5-hmC levels in GCs and explore its association with clinicopathological characteristics and clinical outcome of GC patients. Using immunohistochemistry (IHC) and dot-blot assays, we demonstrated that 5-hmC was dramatically decreased in GCs compared with matched normal tissues. We also found a strong link between decreased 5-hmC and the reduction of TET1 gene expression, but not TET2 or 3, suggesting that decreased TET1 expression might be one of the mechanisms underlying 5-hmC loss in GCs. Wilcoxon tests showed that 5-hmC content was significantly associated with most of clinicopathological characteristics, such as tumor size (P = 0.016), Bormman type (P < 0.0001), tumor invasion (P = 0.001), TNM stage (P < 0.0001), the number of lymph nodes metastasis (P = 0.002), and survival status (P < 0.0001). It is noteworthy that decreased 5-hmC was significantly associated with poor survival of GC patients. Collectively, our findings indicate that decreased 5-hmC may be crucial to the clinical pathology of GC and is a strong and independent poor prognostic factor in GCs. PMID:23980508

Yang, Qi; Wu, Kexia; Ji, Meiju; Jin, Weilin; He, Nongyue; Shi, Bingyin; Hou, Peng



Tumor-infiltrating mast cells in colorectal cancer as a poor prognostic factor.  


The purpose of this study is to investigate the clinical/prognostic significance of tumor-infiltrating mast cells (TIMs) in patients with colorectal cancer (CRC). TIM infiltration in 325 stage I to III CRC specimens was detected by immunohistochemistry. The optimal cutpoint of TIM density was assessed by the X-tile program. TIM infiltration in CRC was significantly higher than in normal colorectal tissues. According to the X-tile program, the cutpoint for high TIM infiltration in CRC was determined when TIM density was more than 8.0 per high-power field. Correlation analysis between TIM density and clinicopathological variables demonstrated that TIM infiltration was significantly associated with gender, nodal status, and American Joint Committee on Cancer stage. Multivariate Cox regression analysis showed that high TIM infiltration was a risk factor for both overall survival and disease-free survival. Taken together, high TIM infiltration can be an independent and useful biomarker for predicting the poor survival of patients with CRC. PMID:22649166

Wu, Xianrui; Zou, Yifeng; He, Xiaosheng; Yuan, Ruixue; Chen, Yufeng; Lan, Nan; Lian, Lei; Wang, Fengwei; Fan, Xinjuan; Zeng, Yang; Ke, Jia; Wu, Xiaojian; Lan, Ping



A Papillary Thyroid Microcarcinoma Revealed by a Single Bone Lesion with No Poor Prognostic Factors  

PubMed Central

Objectives. Thyroid carcinomas incidence, in particular papillary variants, is increasing. These cancers are generally considered to have excellent prognosis, and papillary microcarcinomas are usually noninvasive. Many prognostic histopathology factors have been described to guide therapeutic decisions. Most patients are treated with total thyroidectomy without radioiodine treatment or partial surgery. Case Summary. A 65-year-old man with no significant medical history presented with pain in the left chest wall that had been present for several months. A computed tomography (CT) found a large tissue mass of 4?cm responsible for lysis of the middle arch of the 4th rib on the left. It was a single lesion, highly hypermetabolic on the 18-FDG PET/CT. The histology analysis of the biopsy and surgical specimen favored an adenocarcinoma with immunostaining positive for TTF1 and thyroglobulin (Tg). The total thyroidectomy carried out subsequently revealed a 4?mm papillary microcarcinoma with vesicular architecture of the right lobe, well delimited and distant from the capsule without vascular embolisms. After two radioiodine treatments, the patient is in complete clinical, biological, and radiological remission. Conclusion. This extremely rare case of a singular bone metastasis revealing a papillary thyroid microcarcinoma illustrates the necessity of further research to better characterize the forms of papillary thyroid microcarcinomas with potentially poor prognosis.

Godbert, Yann; Henriques-Figueiredo, Benedicte; Cazeau, Anne-Laure; Carrat, Xavier; Stegen, Marc; Soubeyran, Isabelle; Bonichon, Francoise



A papillary thyroid microcarcinoma revealed by a single bone lesion with no poor prognostic factors.  


Objectives. Thyroid carcinomas incidence, in particular papillary variants, is increasing. These cancers are generally considered to have excellent prognosis, and papillary microcarcinomas are usually noninvasive. Many prognostic histopathology factors have been described to guide therapeutic decisions. Most patients are treated with total thyroidectomy without radioiodine treatment or partial surgery. Case Summary. A 65-year-old man with no significant medical history presented with pain in the left chest wall that had been present for several months. A computed tomography (CT) found a large tissue mass of 4?cm responsible for lysis of the middle arch of the 4th rib on the left. It was a single lesion, highly hypermetabolic on the 18-FDG PET/CT. The histology analysis of the biopsy and surgical specimen favored an adenocarcinoma with immunostaining positive for TTF1 and thyroglobulin (Tg). The total thyroidectomy carried out subsequently revealed a 4?mm papillary microcarcinoma with vesicular architecture of the right lobe, well delimited and distant from the capsule without vascular embolisms. After two radioiodine treatments, the patient is in complete clinical, biological, and radiological remission. Conclusion. This extremely rare case of a singular bone metastasis revealing a papillary thyroid microcarcinoma illustrates the necessity of further research to better characterize the forms of papillary thyroid microcarcinomas with potentially poor prognosis. PMID:23509641

Godbert, Yann; Henriques-Figueiredo, Benedicte; Cazeau, Anne-Laure; Carrat, Xavier; Stegen, Marc; Soubeyran, Isabelle; Bonichon, Francoise



Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer.  


Background:The neutrophil-lymphocyte ratio (NLR) has been proposed as an indicator of systemic inflammatory response. Previous findings from small-scale studies revealed conflicting results about its independent prognostic significance with regard to different clinical end points in pancreatic cancer (PC) patients. Therefore, the aim of our study was the external validation of the prognostic significance of NLR in a large cohort of PC patients.Methods:Data from 371 consecutive PC patients, treated between 2004 and 2010 at a single centre, were evaluated retrospectively. The whole cohort was stratified into two groups according to the treatment modality. Group 1 comprised 261 patients with inoperable PC at diagnosis and group 2 comprised 110 patients with surgically resected PC. Cancer-specific survival (CSS) was assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of the NLR, the modified Glasgow prognostic score (mGPS) and the platelet-lymphocyte ratio univariate and multivariate Cox regression models were applied.Results:Multivariate analysis identified increased NLR as an independent prognostic factor for inoperable PC patients (hazard ratio (HR)=2.53, confidence interval (CI)=1.64-3.91, P<0.001) and surgically resected PC patients (HR=1.61, CI=1.02-2.53, P=0.039). In inoperable PC patients, the mGPS was associated with poor CSS only in univariate analysis (HR=1.44, CI=1.04-1.98).Conclusion:Risk prediction for cancer-related end points using NLR does add independent prognostic information to other well-established prognostic factors in patients with PC, regardless of the undergoing therapeutic modality. Thus, the NLR should be considered for future individual risk assessment in patients with PC. PMID:23799847

Stotz, M; Gerger, A; Eisner, F; Szkandera, J; Loibner, H; L Ress, A; Kornprat, P; A Zoughbi, W; Seggewies, F S; Lackner, C; Stojakovic, T; Samonigg, H; Hoefler, G; Pichler, M



Primary CNS lymphoma in HIV positive and negative patients: comparison of clinical characteristics, outcome and prognostic factors  

Microsoft Academic Search

Primary central nervous system lymphoma (PCNSL) accounts for approximately 4% of all primary brain tumors and has a poor prognosis\\u000a in both immunocompetent as well as in immunocompromised patients. We conducted a retrospective analysis to examine the clinical\\u000a characteristics and prognostic factors in HIV-negative and HIV-positive patients with PCNSL and to assess the effect of highly\\u000a active antiretroviral therapy (HAART)

Soley Bayraktar; Ulas D. Bayraktar; Juan C. Ramos; Alexandra Stefanovic; Izidore S. Lossos



Nonsustained Ventricular Tachycardia in the Setting of Acute Myocardial Infarction Tachycardia Characteristics and Their Prognostic Implications  

Microsoft Academic Search

Background—Nonsustained ventricular tachycardia (NSVT) has significant prognostic implications in the setting of healing and healed myocardial infarction (MI), but only limited information is available on its importance in the setting of acute MI. We evaluated the prognostic significance of NSVT characteristics in the setting of acute MI. Methods and Results—A prospective database was used to identify 112 patients with NSVT

Asim N. Cheema; Kathleen Sheu; Michele Parker; Alan H. Kadish; Jeffrey J. Goldberger


Phosphorylated insulin-like growth factor-1 receptor (pIGF1R) is a poor prognostic factor in brain metastases from lung adenocarcinomas.  


A greater understanding of brain metastases is imperative for developing novel therapeutic strategies. Our previous study showed that insulin-like growth factor (IGF) signaling pathway was activated in brain-tropic cancer cells. In this study, we investigated the clinical relevance of activated (phosphorylated) IGF-1 receptor (pIGF1R) expression in brain metastases originating from lung adenocarcinomas. All pathologically confirmed brain metastases from lung adenocarcinomas, with available archived specimens from January 1998 to December 2009 at National Taiwan University Hospital, were assessed immunohistochemically for pIGF1R expression using H-score criteria. A median H-score was used as a cutoff point to define high or low pIGF1R expression. The mutation status in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) was examined using direct sequencing. The prognostic significance of pIGF1R expression, its correlations with clinicopathological characteristics, and EGFR status were evaluated. In the 86 cases, high membranous/cytoplasmic pIGF1R expression in brain metastases correlated with a shorter median survival (10.8 vs 27.8 mo, P = 0.003). This correlation was more significant in patients with EGFR mutations [hazard ratio (HR) 2.38, 95 % confidence interval (CI) 1.19-4.77 for EGFR mutations; HR 1.99, 95 % CI 0.95-4.15 for EGFR wild type] and remained statistically significant in multivariate analysis after adjusting for the effects of other potential prognostic factors, including the graded prognostic assessment score, solitary brain metastasis, extracranial metastatic status, EGFR mutations, and treatment using EGFR tyrosine kinase inhibitors. Although we also identified nuclear pIGF1R expression, this result was prognostically non-significant. Our study results showed that high membranous/cytoplasmic pIGF1R expression in brain metastases was a poor prognostic factor, more significantly in patients with EGFR mutations than in those with wild-type EGFRs. PMID:23817810

Wu, Pei-Fang; Huang, Wen-Chang; Yang, James Chih-Hsin; Lu, Yen-Shen; Shih, Jin-Yuan; Wu, Shang-Gin; Lin, Ching-Hung; Cheng, Ann-Lii



Atypical p-ANCA is not a poor prognostic marker in Postinfectious Glomerulonephritis  

Microsoft Academic Search

Postinfectious glomerulonephritis (PIGN) most commonly follows streptococcal infection. Antineutrophil cytoplasmic antibodies\\u000a (ANCA) are characteristically negative in PIGN. We report on five cases who had positive atypical pANCA at presentation. The\\u000a outcome was typical of other cases of PIGN with complete resolution of the glomerulonephritis in all five patients. Atypical\\u000a pANCA occurs in a number of inflammatory conditions and antigenic targets

Aoife Waters; Valerie Langlois; Paul Thorner; Denis Geary



Enhancer of Zeste Homolog 2 Overexpression in Nasopharyngeal Carcinoma: An Independent Poor Prognosticator That Enhances Cell Growth  

SciTech Connect

Purpose: As a key component of polycomb-repressive complex 2, enhancer of zeste homolog 2 (EZH2) represses target genes through histone methylation and is frequently overexpressed and associated with poor prognosis in common carcinomas. For the first time, we reported EZH2 expression and its biological and clinical significance in nasopharyngeal carcinoma (NPC). Methods and Materials: In NPC cell lines and specimens, endogenous expression of EZH2 mRNA and protein was determined by semiquantitative reverse transcription-polymerase chain reaction and immunoblotting, respectively. To analyze the effect on cell growth, stable silencing of EZH2 was established in EZH2-expressing TW02 NPC cells with RNA interference. EZH2 immunolabeling was assessable for 89 primary NPC biopsy samples and correlated with clinicopathological variables, disease-specific survival (DSS), and overall survival (OS). Results: Growth activity of TW02 cells was significantly suppressed (p < 0.001) with stable EZH2 silencing. Compared with normal nasopharyngeal tissue, expression levels of EZH2 transcript and protein were apparently upregulated in NPC specimens. As a continuous variable, higher EZH2 expression preferentially occurred in NPCs of T3 to T4 stages (p = 0.03) and significantly predicted inferior DSS (p = 0.0010) and OS (p = 0.004). The prognostic implications for DSS (p = 0.010) and OS (p = 0.006) still remained valid when using the median ({>=}60%) of EZH2 immunolabeling index to dichotomize the cohort. In the multivariate model, higher EZH2 expression was an independent adverse factor of both DSS (p = 0.012) and OS (p = 0.011), along with American Joint Committee on Cancer Stages III to IV (p = 0.024 for DSS, p = 0.017 for OS). Conclusion: At least partly through promoting cell growth, EZH2 implicates disease progression, confers tumor aggressiveness, and represents an independent adverse prognosticator in patients with NPC.

Hwang, Chung-Feng [Department of Otolaryngology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Huang, Hsuan-Ying [Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Chen, Chang-Han [Department of Otolaryngology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Center for Translational Research in Biomedical Sciences, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Chien, Chih-Yen; Hsu, Yao-Chung [Department of Otolaryngology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Li, Chien-Feng [Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan (China); Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung, Taiwan (China); and others



Prognostic indicators of poor outcome in horses with laminitis at a tertiary care hospital  

PubMed Central

This retrospective study investigated the factors associated with a poor outcome (death by euthanasia or from other causes) in horses treated for laminitis at a tertiary care hospital. Cases (n = 247) were defined as patients with laminitis that were euthanized or that died of other causes during hospitalization. Controls (n = 344) were patients with laminitis that survived to be discharged from the hospital. In the final multivariate analysis, the factors significantly associated with an increased risk for death and their respective odds ratios (OR) were as follows: Thoroughbred (OR = 1.57); racehorse (OR = 1.76); treatment with flunixin meglumine (OR = 1.76); vascular pathology (OR = 2.12); distal displacement of the third phalanx (OR = 2.68); pneumonia (OR = 2.87); and lameness of Obel grade II (OR = 2.99), grade III (OR = 9.63), or grade IV (OR = 20.48). The use of glue-on shoes significantly reduced the risk for death (OR = 0.36).

Orsini, James A.; Parsons, Corrina Snook; Capewell, Linda; Smith, Gary



CRM1 is a novel independent prognostic factor for the poor prognosis of gastric carcinomas.  


Gastric cancer (GC) is a highly aggressive malignant tumor. Its high mortality rate prompts the urgent need for novel therapeutic agents. The aim of this study is to detect the expression of CRM1 in GC, which has not been reported to date. The expression of CRM1 in GC and adjacent noncancerous tissues (ANCT) of gastrectomy specimens from 120 GC patients was measured by immunohistochemistry. In addition, correlations between the CRM1 staining and the clinicopathologic features as well as survival were analyzed. Positive expression rates of CRM1 in GC and ANCT were 57.8 and 6.7 %, respectively. High expression of CRM1 was significantly associated with increased serum level of carcinoma embryonic antigen (CEA, P = 0.02) but not associated with that of carbohydrate antigen 19-9 (P = 0.38). CRM1 levels were correlated with more advanced tumor stages (P = 0.01), positive Her2 status (P = 0.01), and distant metastasis (P = 0.02). Univariate analysis showed that CEA (P = 0.0076), TNM stage (P = 0.0001), metastasis (P = 0.027), and CRM1 expression (P = 0.0019) were significant risk factors affecting overall survival of GC patients. The multivariate analysis indicated that the CRM1 was an independent indicator for GC survival (P = 0.0048). The current results indicated that CRM1 expressed in a subpopulation of GC with aggressive behavior and could serve as a prognosis marker for poor outcome. PMID:24026662

Zhou, Fang; Qiu, Wensheng; Yao, Ruyong; Xiang, Jinyu; Sun, Xiaoxiao; Liu, Shihai; Lv, Jing; Yue, Lu



Single-center analysis of biopsy-confirmed posttransplant lymphoproliferative disorder: incidence, clinicopathological characteristics and prognostic factors.  


Hematopoietic stem cell and solid organ transplant recipients diagnosed with biopsy-confirmed posttransplant lymphoproliferative disorder (PTLD) at our institution from 1989 to 2010 were identified. Patient-, transplant- and disease-related characteristics, prognostic factors and outcome were collected and analyzed. One hundred and forty biopsy-proven cases of PTLD were included. Overall incidence in the transplant population was 2.12%, with heart transplant recipients carrying the highest risk. Most PTLDs were monomorphic (82%), with diffuse large B-cell lymphoma being the most frequent subtype. The majority of cases (70.7%) occurred > 1 year posttransplant, and 66% were Epstein-Barr virus positive. Following initial therapy the overall response rate was 68.5%. Three-year relapse-free and overall survivals were 59% and 49%, respectively. At last follow-up, 44% of the patients were alive. Multivariable analysis identified several classical lymphoma-specific poor prognostic factors for the different outcome measures. The value of the International Prognostic Index was confirmed in our analysis. PMID:23442063

Dierickx, Daan; Tousseyn, Thomas; Sagaert, Xavier; Fieuws, Steffen; Wlodarska, Iwona; Morscio, Julie; Brepoels, Lieselot; Kuypers, Dirk; Vanhaecke, Johan; Nevens, Frederik; Verleden, Geert; Van Damme-Lombaerts, Rita; Renard, Marleen; Pirenne, Jacques; De Wolf-Peeters, Christiane; Verhoef, Gregor



Characteristic Reading Behaviors of Poor Readers Who Have Learning Disabilities  

ERIC Educational Resources Information Center

|Most students who receive special education services have significant difficulties with reading. Because teachers are considered the major source of referral for special education services, they must know the characteristic reading behaviors that distinguish students with reading disabilities. The purpose of this study was to validate…

Bryant, Diane P.; Bryant, Brian R.; Hammill, Donald D.; McCray Sorrells, Audrey; Kethley, Caroline I.



Primary gastric non-Hodgkin's lymphoma in Chinese patients: clinical characteristics and prognostic factors  

Microsoft Academic Search

BACKGROUND: Optimal management and outcome of primary gastric lymphoma (PGL) have not been well defined in the rituximab era. This study aimed to analyze the clinical characteristics, prognostic factors, and roles of different treatment modalities in Chinese patients with PGL. METHODS: The clinicopathological features of 83 Chinese patients with PGL were retrospectively reviewed. Staging was performed according to the Lugano

JiaJia Huang; WenQi Jiang; RuiHua Xu; HuiQiang Huang; Yue Lv; ZhongJun Xia; XiaoFei Sun; ZhongZhen Guan; TongYu Lin; ZhiMing Li



Origins of the Poor Filtration Characteristics of Wheat Starch Hydrolysates  

Microsoft Academic Search

Cereal Chem. 75(3):289-293 The effects of wheat starch components on the f iltration characteristics of wheat starch hydrolysates were investigated with a model-based approach. The filtration rate was not affected by the removal of the pen- tosans or by altering the conformation of the protein. On the other hand, the filtration rate increased when a hydrolysate was defatted with chloro-

Ariette M. Matser; Peter A. M. Steeneken



Ribonucleotide reductase small subunit M2 serves as a prognostic biomarker and predicts poor survival of colorectal cancers.  


The overexpression of RRM2 [RR (ribonucleotide reductase) small subunit M2] dramatically enhances the ability of the cancer cell to proliferate and to invade. To investigate further the relevance of RRM2 and CRCs (colorectal cancers), we correlated the expression of RRM2 with the clinical outcome of CRCs. A retrospective outcome study was conducted on CRCs collected from the COH [(City of Hope) National Medical Center, 217 cases] and ZJU (Zhejiang University, 220 cases). IHC (immunohistochemistry) was employed to determine the protein expression level of RRM2, and quantitative real-time PCR was employed to validate. Multivariate logistic analysis indicated that the adjusted ORs (odds ratios) of RRM2-high for distant metastases were 2.06 [95% CI (confidence interval), 1.01-4.30] and 5.89 (95% CI, 1.51-39.13) in the COH and ZJU sets respectively. The Kaplan-Meier analysis displayed that high expression of RRM2 had a negative impact on the OS (overall survival) and PFS (progress-free survival) of CRC in both sets significantly. The multivariate Cox analysis further demonstrated that HRs (hazard ratios) of RRM2-high for OS were 1.88 (95% CI, 1.03-3.36) and 2.06 (95% CI, 1.10-4.00) in the COH and ZJU sets respectively. Stratification analysis demonstrated that the HR of RRM2 dramatically increased to 12.22 (95% CI, 1.62-258.31) in the MMR (mismatch repair) gene-deficient subgroup in the COH set. Meanwhile, a real-time study demonstrated that down-regulation of RRM2 by siRNA (small interfering RNA) could significantly and specifically reduce the cell growth and adhesion ability in HT-29 and HCT-8 cells. Therefore RRM2 is an independent prognostic factor and predicts poor survival of CRCs. It is also a potential predictor for identifying good responders to chemotherapy for CRCs. PMID:23113760

Liu, Xiyong; Zhang, Hang; Lai, Lily; Wang, Xiaochen; Loera, Sofia; Xue, Lijun; He, Huiyin; Zhang, Keqiang; Hu, Shuya; Huang, Yasheng; Nelson, Rebecca A; Zhou, Bingsen; Zhou, Lun; Chu, Peiguo; Zhang, Suzhan; Zheng, Shu; Yen, Yun



Prognostic factors and epidemiological characteristics of cutaneous and mucosal head and neck melanoma.  


OBJECTIVE. To describe the prognostic factors and epidemiological characteristics of cutaneous and mucosal head and neck melanoma and to identify the variables associated with mortality from this disease. MATERIAL AND METHODS. Patients treated for head and neck melanoma in the Oncology Centre of Latvia, Riga during a 10-year period were identified. Records from 124 cases were analyzed in a descriptive, retrospective study. For each patient, information regarding age, sex, tumor anatomic site, as well as ulceration, histological tumor subtypes, Breslow thickness and Clark invasion level was viewed. Disease specific survival rates were calculated. The frequencies of all study variables and their 95% confidence intervals were determined. Kaplan-Meier survival curves were produced to illustrate the survival differences for each variable. RESULTS. The patients' mean age was 67.36 years. The study included 81 females (65.32%) and 43 males (34.67%). The prevalent anatomical site for cutaneous head and neck melanoma was the cheek - 49% (n=55) and the intraocular site for mucosal melanoma (61.5%). A high percentage of thick cutaneous melanoma was detected. In 53 cases (47.3%) out of 112 cutaneous melanoma the tumor ulceration was found. Nodular melanoma subtype was predominating (38%). The incidence of cutaneous melanoma has increased unequally whereas mucosal melanoma of the head and neck is an uncommon cancer and the incidence rates in Latvia during a ten year period are decreasing. CONCLUSION. Female sex, advanced age, facial skin, tumor thickness, nodular subtype and ulceration carried a relevant risk of poor prognosis. PMID:21822045

Berzina, Anna; Azarjana, Kristine; Cema, Ingrida; Pjanova, Dace; Rivosh, Alexander



Fractal Characteristics of May-Grünwald-Giemsa Stained Chromatin Are Independent Prognostic Factors for Survival in Multiple Myeloma  

Microsoft Academic Search

BackgroundThe use of computerized image analysis for the study of nuclear texture features has provided important prognostic information for several neoplasias. Recently fractal characteristics of the chromatin structure in routinely stained smears have shown to be independent prognostic factors in acute leukemia. In the present study we investigated the influence of the fractal dimension (FD) of chromatin on survival of

Daniela P. Ferro; Monica A. Falconi; Randall L. Adam; Manoela M. Ortega; Carmen P. Lima; Carmino A. de Souza; Irene Lorand-Metze; Konradin Metze



Primary mediastinal large B-cell lymphoma (PMLBCL) in Chinese patients: clinical characteristics and prognostic factors  

Microsoft Academic Search

Primary mediastinal large B-cell lymphoma (PMLBCL) is a unique clinico-pathological subtype, for which there is no optimal\\u000a therapy yet. We evaluated clinical characteristics and prognostic factors in 39 consecutive, previously untreated Chinese\\u000a patients with PMLBCL. The median age was 28 years (range 16–72 years). The majority of patients were stage I\\/II (23 cases,\\u000a 59%). Bulky mediastinal mass was present in 18 cases

Ying-Jie ZhuJia-Jia; Jia-Jia Huang; Yi Xia; Wei Zhao; Wen-Qi Jiang; Tong-Yu Lin; Hui-Qiang Huang; Zhi-Ming Li


Colorectal poorly differentiated neuroendocrine carcinomas and mixed adenoneuroendocrine carcinomas: insights into the diagnostic immunophenotype, assessment of methylation profile, and search for prognostic markers.  


Colorectal poorly differentiated neuroendocrine carcinomas (NECs) and mixed adenoneuroendocrine carcinomas (MANECs) are well-recognized entities generally known to be associated with biological aggressiveness and poor patient survival. However, a few published papers have highlighted the existence of a subgroup of tumors with a better survival than expected; however, to date, there are no established parameters that usefully identify this category. In the present study we have investigated the morphologic features, the CpG methylator phenotype (CIMP), microsatellite instability (MSI), and the immunohistochemical profile, including the expression of transcription factors (TTF1, ASH1, CDX2, and PAX5), stem cell markers (CD117 and CD34), and cytokeratins 7 and 20, in a series of 39 carcinomas (27 NECs and 12 MANECs) to better characterize such neoplasms and to search for prognostic indicators. No different patient survival was observed between NECs and MANECs. Neoplasms showed a heterogenous spectrum of morphologic and immunohistochemical features; however, only large-cell subtype, significant peritumoral lymphoid reaction, CD117 immunoreactivity, vascular invasion, and MSI/CIMP+ status were significantly correlated with prognosis on univariable analysis. Furthermore, vascular invasion and CD117 immunoreactivity were independent prognostic markers on multivariable analysis. In addition to these prognostic features, neoplasms showed different expression of transcription factors, stem cell markers, and cytokeratins that should be considered for diagnostic purposes and, especially, for discriminating among possible differential diagnoses. PMID:22314183

La Rosa, Stefano; Marando, Alessandro; Furlan, Daniela; Sahnane, Nora; Capella, Carlo



Nab-paclitaxel for first-line treatment of patients with metastatic breast cancer and poor prognostic factors: a retrospective analysis.  


Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) has demonstrated clinical benefit in metastatic breast cancer (MBC) in a randomized phase III trial versus paclitaxel (CA012; N = 454) and in a randomized phase II trial versus docetaxel (CA024; N = 300). This retrospective analysis examines whether patients with poor prognostic factors demonstrate similar outcomes to the intent-to-treat (ITT) populations in these trials. This retrospective analysis evaluated the efficacy and safety of previously untreated patients with MBC with the following poor prognostic factors: visceral dominant metastases and short disease-free interval (DFI; ?2 years). In CA012 (n = 186 first-line patients), nab-paclitaxel demonstrated a significantly higher overall response rate (ORR) versus paclitaxel in patients with visceral dominant metastases (42 vs. 23 %; P = 0.022), whereas the higher ORR for nab-paclitaxel in patients with a short DFI (43 vs. 33 %; P = NS) was not statistically significant. In CA024, a significantly higher ORR for nab-paclitaxel 150 mg/m(2) versus docetaxel was observed in patients with visceral dominant metastases (76 vs. 37 %; P < 0.001). No significant differences in ORR were observed in patients with a short DFI. Although progression-free survival (PFS) and overall survival showed trends similar to ORR, statistical significance was only achieved for comparisons of PFS in patients with visceral dominant metastases in CA024 (13.1 months for nab-paclitaxel 150 mg/m(2) vs. 7.8 months for docetaxel [P = 0.019] and 7.5 months for nab-paclitaxel 100 mg/m(2) [P = 0.010]). Safety results were similar to previous reports of the ITT populations. nab-Paclitaxel demonstrated similar efficacy in patients with poor prognostic factors as in the ITT populations of these two trials. In each trial, ORR was significantly higher for nab-paclitaxel versus the comparator taxane among patients with visceral dominant metastases. PMID:23563958

O'Shaughnessy, Joyce; Gradishar, William J; Bhar, Paul; Iglesias, Jose



Research on Good and Poor Reader Characteristics: Implications for L2 Reading Research in China  

ERIC Educational Resources Information Center

In reading research, studies on good and poor reader characteristics abound. However, these findings remain largely scattered in applied linguistics and cognitive and educational psychology. This paper attempts to synthesize current theory and research on the topic in the past 20 years along 3 dimensions: language knowledge and processing ability,…

Pang, Jixian



Clinicopathologic characteristics and prognostic factors of 63 gastric cancer patients with metachronous ovarian metastasis  

PubMed Central

Objective This study aims to explore the clinicopathologic characteristics and prognostic factors of gastric cancer patients with metachronous ovarian metastasis. Methods Clinicopathologic data were collected from 63 post-operative gastric cancer patients with metachronous ovarian metastasis. The patients were admitted to the Cancer Institute and Hospital, Chinese Academy of Medical Science and Peking Union Medical College between January 1999 and December 2011. A log-rank test was conducted for survival analysis. Possible prognostic factors that affect survival were examined by univariate analysis. A Cox regression model was used for multivariate analysis. Results The incidence of ovarian metastasis was 3.4% with a mean age of 45 years. Up to 65.1% of the patients were pre-menopausal. The mean interval between ovarian metastasis and primary cancer was 16 months. Lowly differentiated carcinoma ranked first in the primary gastric cancers. The majority of lesions occurred in the serous membrane (87.3%). The metastatic sites included N2-3 lymph nodes (68.3%), bilateral ovaries (85.7%), and peritoneal membrane (73%). Total resection of metastatic sites was performed (31.7%). The overall median survival was 13.6 months, whereas the overall 1-, 2-, and 3-year survival rates were 52.5%, 22.0%, and 9.8%, respectively. The 5-year survival rate was zero. Univariate analysis showed that the patient prognosis was correlated with metastatic peritoneal seeding, vascular tumor embolus, range of lesion excision, and mode of comprehensive treatment with adjuvant chemotherapy (P<0.05). Multivariate analysis indicated that metastatic peritoneal seeding was an independent prognostic factor for gastric cancer patients with ovarian metastasis (P<0.01). Conclusion Effective control of peritoneal seeding—induced metastasis is important for improving the prognosis of gastric cancer patients with ovarian metastasis.

Feng, Qiang; Pei, Wei; Zheng, Zhao-Xu; Bi, Jian-Jun; Yuan, Xing-Hua



Gender Differences in the Prognostic Value of Exercise Treadmill Test Characteristics  

PubMed Central

Background Although exercise treadmill testing (ETT) is known to be less sensitive and specific for diagnosis of coronary disease in women, little is known about gender differences in the prognostic importance of ETT variables. Methods We studied9569 consecutive patients (46.8% women) referred for ETT between July 2001- June 2004 in a community-based system. We assessed the association between ETT variables (exercise capacity, symptoms, ST-segment deviations, heart rate recovery, and chronotropic response) and time to all-cause death and myocardial infarction adjusting for patient and stress test characteristics. Models were stratified by gender to determine the relationship between ETT variables and outcomes. Results In the entire population, exercise capacity and heart rate recovery were significantly associated with all-cause death, whereas, exercise capacity, chest pain and ST-segment deviations were significantly associated with subsequent MI. The relationship between ETT variables and outcomes were similar between men and women except for abnormal exercise capacity, which was had a significantly stronger association with death in men (men: HR = 2.89, 95% CI 1.89–4.44; women: HR = 0.99, 95% CI 0.52–1.93; interaction prognostic value in both men and women, exercise capacity was more prognostically important in men and chronotropic incompetence was more important in women. Future studies should confirm these findings in additional populations.

Daugherty, Stacie L.; Magid, David J.; Kikla, Jennifer R.; Hokanson, John E.; Baxter, Judith; Ross, Colleen A.; Masoudi, Frederick A.



Gene expression profiling of cholangiocarcinoma-derived fibroblast reveals alterations related to tumor progression and indicates periostin as a poor prognostic marker  

PubMed Central

Background Fibroblasts play important roles in several cancers. It was hypothesized that cholangiocarcinoma (CCA)-associated fibroblasts (Cfs) differ from non-tumorigenic liver fibroblasts (Lfs) in their gene expression profiles resulting in the capability to promote cancer. Periostin (PN) is a multi-functional protein and has emerged as a promising marker for tumor progression. The role of PN in CCA, however, has not yet been explored. Results In this study, the gene expression profile of Cfs in comparison to Lfs was performed using oligonucleotide microarrays. The common- and unique-expressed genes in Cfs and the promising roles in cancer promotion and progression were determined. PN was markedly over-expressed in Cfs confirmed by real time RT-PCR and western blot analysis. Immunohistochemistry examination of a number of patients with intrahepatic CCA showed the expression of PN solely in stromal fibroblasts, but was expressed neither in cancer cells nor immune cells. Low to no expression of PN was observed in tissues of benign liver disease and hepatocellular carcinoma. CCA patients with high levels of PN had significantly shorter survival time than those with low levels (P = 0.026). Multivariate analysis revealed high levels of PN (P = 0.045) and presence of lymph node metastasis (P = 0.002) as independent poor prognostic factors. The in vitro study revealed that recombinant PN induced CCA cell proliferation and invasion. Interestingly, interference RNA against integrin ?5 significantly reduced the cellular response to PN-stimulated proliferation and invasion. Conclusion The gene expression profile of fibroblasts in CCA is apparently explored for the first time and has determined the genes involving in induction of this cancer progression. High PN can be used to distinguish CCA from other related liver diseases and is proposed as a prognostic factor of poor survival. Regulation of fibroblast-derived PN in CCA proliferation and invasion may be considered as an alternative therapeutic approach.



High levels of carbonic anhydrase IX in tumour tissue and plasma are biomarkers of poor prognostic in patients with non-small cell lung cancer  

PubMed Central

Background: Carbonic anhydrase IX (CAIX) is an enzyme upregulated by hypoxia during tumour development and progression. This study was conducted to assess if the expression of CAIX in tumour tissue and/or plasma can be a prognostic factor in patients with non-small cell lung cancer (NSCLC). Methods: Tissue microarrays containing 555 NSCLC tissue samples were generated for quantification of CAIX expression. The plasma level of CAIX was determined by ELISA in 209 of these NSCLC patients and in 58 healthy individuals. The CAIX tissue immunostaining and plasma levels were correlated with clinicopathological factors and patient outcome. Results: CAIX tissue overexpression correlated with shorter overall survival (OS) (P=0.05) and disease-specific survival (DSS) of patients (P=0.002). The CAIX plasma level was significantly higher in patients with NSCLC than in healthy individuals (P<0.001). A high level of CAIX in the plasma of patients was associated with shorter OS (P<0.001) and DSS (P<0.001), mostly in early stage I+II NSCLC. Multivariate Cox analyses revealed that high CAIX tissue expression (P=0.002) was a factor of poor prognosis in patients with resectable NSCLC. In addition, a high CAIX plasma level was an independent variable predicting poor OS (P<0.001) in patients with NSCLC. Conclusion: High expression of CAIX in tumour tissue is a predictor of worse survival, and a high CAIX plasma level is an independent prognostic biomarker in patients with NSCLC, in particular in early-stage I+II carcinomas.

Ilie, M; Mazure, N M; Hofman, V; Ammadi, R E; Ortholan, C; Bonnetaud, C; Havet, K; Venissac, N; Mograbi, B; Mouroux, J; Pouyssegur, J; Hofman, P



Overexpression of Nuclear Protein Kinase CK2 ? Catalytic Subunit (CK2?) as a Poor Prognosticator in Human Colorectal Cancer  

PubMed Central

Background Colorectal cancer (CRC) is one of the most common malignancies but the current therapeutic approaches for advanced CRC are less efficient. Thus, novel therapeutic approaches are badly needed. The purpose of this study is to investigate the involvement of nuclear protein kinase CK2 ? subunit (CK2?) in tumor progression, and in the prognosis of human CRC. Methodology/Principal Findings Expression levels of nuclear CK2? were analyzed in 245 colorectal tissues from patients with CRC by immunohistochemistry, quantitative real-time PCR and Western blot. We correlated the expression levels with clinicopathologic parameters and prognosis in human CRC patients. Overexpression of nuclear CK2? was significantly correlated with depth of invasion, nodal status, American Joint Committee on Cancer (AJCC) staging, degree of differentiation, and perineural invasion. Patients with high expression levels of nuclear CK2? had a significantly poorer overall survival rate compared with patients with low expression levels of nuclear CK2?. In multi-variate Cox regression analysis, overexpression of nuclear CK2? was proven to be an independent prognostic marker for CRC. In addition, DLD-1 human colon cancer cells were employed as a cellular model to study the role of CK2? on cell growth, and the expression of CK2? in DLD-1 cells was inhibited by using siRNA technology. The data indicated that CK2?-specific siRNA treatment resulted in growth inhibition. Conclusions/Significance Taken together, overexpression of nuclear CK2? can be a useful marker for predicting the outcome of patients with CRC.

Hsu, Jung-Chin; Li, Chien-Feng; Fang, Chia-Lang; Lai, Hsi-Chin; Hseu, You-Cheng; Lin, Yi-Feng; Uen, Yih-Huei



Management of headache disorders: design of a randomised clinical trial screening for prognostic patient characteristics  

PubMed Central

Background Treatment of headache disorders is not always optimal. Patients are treated in multiple ways, and the lack of scientific arguments for referral and the insufficient implementation of guidelines result in unclear treatment strategies. The coexistence of headache and neck pain can lead to the referral to a musculoskeletal physiotherapist. This treatment can only be successful if an underlying cervical segmental dysfunction is present. In such cases a physical treatment can be a valuable option that should be considered. The aim of this study is to identify prognostic therapeutic patient characteristics and to increase the number of correct physiotherapy referrals. Methods/design This trial is designed to identify patient characteristics which can influence the prognosis of the patient. Patients with recurrent headache and co-existent neck pain are recruited via a multicenter setup. After screening for eligibility, subjects are tested at baseline and randomly allocated to one of two treatment groups. Testing includes the administering of questionnaires (a Headache Diagnosis Questionnaire, Headache Inventory List and the Headache Impact Test (HIT-6)) and physical tests (Thermal Stimuli, Manual Cervical Spine Examination and Pressure Algometry). Treatment groups are a usual care group (UC) administered by the General Practitioner (GP) and a usual care plus musculoskeletal physiotherapy treatment group (UCMT). UC is based on the Dutch GP Guideline for Headache. UCMT consists of the UC plus a combination of exercises and spinal cervical mobilisations. Follow-up measurements consist of the completion of the Headache Inventory List, the HIT-6 and scoring of the global perceived effect (GPE). The latter allowing the distinction between responders (positive effect) and non-responders (no effect or worse). Logistic regression analysis will be used to identify the specific patient characteristics of the responders and the non-responders. The additional value of the musculoskeletal physiotherapy will be examined. Follow-up measurements up to 52 weeks are scheduled. Discussion This trial aims to identify prognostic patient characteristics, in order to supply a useful diagnostic tool for all health care workers, dealing with headache sufferers.

De Hertogh, Willem J; Vaes, Peter H; Devroey, Dirk; Truijen, Steven; Duquet, William; Oostendorp, Rob



Thyroid gland papillary carcinomas with "micropapillary pattern," a recently recognized poor prognostic finding: clinicopathologic and survival analysis of 7 cases.  


Micropapillary carcinoma is a histologic pattern, rather than an independent entity, that has an aggressive clinical behavior regardless of location. Histologically, it is characterized by papillary cell groups in clear spaces. The micropapillary pattern in the thyroid gland has not been studied until recently but under other names such as hobnail features or oncocytic and, therefore, is poorly understood, and reported cases are few. We report the clinicopathologic features of 7 cases obtained from a cohort of 496 papillary thyroid carcinomas, which corresponds to a prevalence of 1.4%. The proportion of the micropapillary component accounted for between 5% and 20% of the tumors, was slightly more prevalent in men, correlated with the presence of lymphovascular permeation, and, in the survival analysis, showed lower survival (even at a short follow-up, 8.5 years) than conventional carcinoma without this component (P = .001); this is consistent with poor overall survival in the short term (2-5 years) reported for carcinomas with micropapillary pattern of other locations. We believe that owing to this difference in survival (>95% of patients with conventional papillary carcinoma are alive at 8.5 years versus 42% of those having at least 5% of micropapillary pattern), the micropapillary pattern should be correctly identified and stated in the pathology report when comprising at least 5% of the tumor. PMID:22425190

Lino-Silva, Leonardo Saúl; Domínguez-Malagón, Hugo R; Caro-Sánchez, Claudia Haydee; Salcedo-Hernández, Rosa Angélica



Characteristics of ventricular extrasystoles and their prognostic importance: a reappraisal of their method of classification.  


The concept of two different types of extrasystoles, parasystolic and coupled, depends upon two distinguishing characteristics of these beats. The characteristics of the parasystolic extrasystoles are the invariability of the ectopic cycle together with their independence from the basic rhythm. Coupled extrasystoles demonstrate a dependence upon the basic rhythm although they may express some degree of ectopic variability. The degree of variation of the interectopic interval or its common denominator measures the irregularity of the ectopic parasystolic rhythm. The variation of coupling intervals describes the dependence of the ectopic beat upon the basic rhythm. In a study of 719 electrocardiograms with ventricular extrasystoles, about one-third of the extrasystoles appeared intermediate between these types since they had both variable coupling intervals and variable interectopic intervals. Some of these had total variability of coupling intervals and of the interectopic intervals (random non-parasystolic coupling), and others had limited variation of coupling intervals when expressed in relationship to the total duration of electrical diastole (approximate non-parasystolic coupling). Both these ectopic types appeared to be associated with cardiac disease, and repetitive ventricular extrasystoles. Left bundle branch type extra-with fixed coupling. There were no obvious relationships between the contour and the type of coupling of ventricular extrasystoles. Left bundle branch type extrasystoles with vertical or right axis were the most frequent, particularly in normal subjects, but in the presence of cardiac disease there were more electrocardiograms with right bundle branch type extrasystoles. Extrasystoles in the presence of underlying conduction defects were usually of opposite configuration to this defect. The contour of uniform extrasystoles did not appear to predispose to serious ventricular arrhythmias but multiformity of extrasystoles was an important prognostic indicator. It is suggested that variability of contour and coupling are important signs of inhomogenous conduction and may precede the onset of severe ventricular arrhythmias. Random nonparasystolic coupling and marked multiformity indicate a more sinister arrhythmic state. PMID:47803

Talbot, S; Dreifus, L S



Cognitive-Motivational Characteristics of Children Varying in Reading Ability: Evidence for Learned Helplessness in Poor Readers.  

ERIC Educational Resources Information Center

Fifth-grade boys of relatively good, average, and poor reading ability were assessed on tasks in which success and failure were manipulated. Consistent with predictions, poor readers displayed characteristics indicative of learned helplessness and low self-concepts of ability, including low expectations and less persistence. (Instructional…

Butkowsky, Irwin S.; Willows, Dale M.



Prognostic role of clinical, pathological and biological characteristics in patients with locally advanced breast cancer.  

PubMed Central

Forty-two patients with clinical stage IIIA or IIIB breast cancer were treated with neoadjuvant chemotherapy followed by mastectomy and radiotherapy. The median follow-up was 32 months (range 10-72 months) and the median time to progression was 17 months (range 10-30 months). A multivariate analysis showed that a longer disease-free survival (DFS) was related to more chemotherapy cycles given (P = 0.003), a better pathological response to chemotherapy (P = 0.04) and fewer positive axillary lymph nodes (P = 0.05). A better overall survival (OS) was related to more chemotherapy cycles given (P = 0.03) and better pathological response to chemotherapy (P = 0.04). In patients with residual tumour after neoadjuvant chemotherapy, high levels of staining for Ki-67 was correlated with a worse DFS (P = 0.008). Other biological characteristics, including oestrogen receptor status, microvessel density (CD31 staining), P-glycoprotein (P-gp) staining and nuclear accumulation of p53, were not independent prognostic factors for either DFS or OS. If both P-gp and p53 were expressed, DFS and OS were worse in the uni- and multivariate analysis. The preliminary results of this phase II study suggest that coexpression of P-gp/p53 and a high level of staining for Ki-67 after chemotherapy are associated with a worse prognosis, and that prolonged neoadjuvant chemotherapy and the attainment of a pathological complete remission are important factors in determining outcome for patients with this disease.

Honkoop, A. H.; van Diest, P. J.; de Jong, J. S.; Linn, S. C.; Giaccone, G.; Hoekman, K.; Wagstaff, J.; Pinedo, H. M.



Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol  

PubMed Central

Background Low-back related leg pain with or without nerve root involvement is associated with a poor prognosis compared to low back pain (LBP) alone. Compared to the literature investigating prognostic indicators of outcome for LBP, there is limited evidence on prognostic factors for low back-related leg pain including the group with nerve root pain. This 1 year prospective consultation-based observational cohort study will describe the clinical, imaging, demographic characteristics and health economic outcomes for the whole cohort, will investigate differences and identify prognostic indicators of outcome (i.e. change in disability at 12 months), for the whole cohort and, separately, for those classified with and without nerve root pain. In addition, nested qualitative studies will provide insights on the clinical consultation and the impact of diagnosis and treatment on patients' symptom management and illness trajectory. Methods Adults aged 18 years and over consulting their General Practitioner (GP) with LBP and radiating leg pain of any duration at (n = 500) GP practices in North Staffordshire and Stoke-on-Trent, UK will be invited to participate. All participants will receive a standardised assessment at the clinic by a study physiotherapist and will be classified according to the clinically determined presence or absence of nerve root pain/involvement. All will undergo a lumbar spine MRI scan. All participants will be managed according to their clinical need. The study outcomes will be measured at 4 and 12 months using postal self-complete questionnaires. Data will also be collected each month using brief postal questionnaires to enable detailed description of the course of low back and leg pain over time. Clinical observations and patient interviews will be used for the qualitative aspects of the study. Discussion This prospective clinical observational cohort will combine self-reported data, comprehensive clinical and MRI assessment, together with qualitative enquiries, to describe the course, health care usage, patients' experiences and prognostic indicators in an adult population presenting in primary care with LBP and leg pain with or without nerve root involvement.



Clinical characteristics and prognostic analysis of Chinese patients with diffuse large B-cell lymphoma  

Microsoft Academic Search

Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma in adults. As it is a highly heterogenous disease, many studies have focused on finding useful prognostic factors to help guide therapy. In this report, we examine several biological markers in 83 patients with DLBCL enrolled in our hospital, including cell origin, serum lactate dehydrogenase (LDH) levels, and

Xiaoyan Ke; Jing Wang; Zifen Gao; Lingzhi Zhao; Min Li; Hongmei Jing; Jijun Wang; Wei Zhao; Heather Gilbert; Xiao-Feng Yang



A phase III randomized trial of postoperative pelvic irradiation in stage IB cervical carcinoma with poor prognostic features: Follow-up of a gynecologic oncology group study  

SciTech Connect

Purpose: To investigate, in a phase III randomized trial, whether postoperative external-beam irradiation to the standard pelvic field improves the recurrence-free interval and overall survival (OS) in women with Stage IB cervical cancers with negative lymph nodes and certain poor prognostic features treated by radical hysterectomy and pelvic lymphadenectomy. Methods and Materials: Eligible patients had Stage IB cervical cancer with negative lymph nodes but with 2 or more of the following features: more than one third (deep) stromal invasion, capillary lymphatic space involvement, and tumor diameter of 4 cm or more. The study group included 277 patients: 137 randomized to pelvic irradiation (RT) and 140 randomized to observation (OBS). The planned pelvic dose was from 46 Gy in 23 fractions to 50.4 Gy in 28 fractions. Results: Of the 67 recurrences, 24 were in the RT arm and 43 were in the OBS arm. The RT arm showed a statistically significant (46%) reduction in risk of recurrence (hazard ratio [HR] = 0.54, 90% confidence interval [CI] = 0.35 to 0.81, p = 0.007) and a statistically significant reduction in risk of progression or death (HR = 0.58, 90% CI = 0.40 to 0.85, p = 0.009). With RT, 8.8% of patients (3 of 34) with adenosquamous or adenocarcinoma tumors recurred vs. 44.0% (11 of 25) in OBS. Fewer recurrences were seen with RT in patients with adenocarcinoma or adenosquamous histologies relative to others (HR for RT by histology interaction = 0.23, 90% CI = 0.07 to 0.74, p = 0.019). After an extensive follow-up period, 67 deaths have occurred: 27 RT patients and 40 OBS patients. The improvement in overall survival (HR = 0.70, 90% CI = 0.45 to 1.05, p = 0.074) with RT did not reach statistical significance. Conclusions: Pelvic radiotherapy after radical surgery significantly reduces the risk of recurrence and prolongs progression-free survival in women with Stage IB cervical cancer. RT appears to be particularly beneficial for patients with adenocarcinoma or adenosquamous histologies. Circumstances that may have influenced the overall survival differences are considered.

Rotman, Marvin [Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY (United States)]. E-mail:; Sedlis, Alexander [Department of Obstetrics and Gynecology, SUNY Downstate Medical Center, Brooklyn, NY (United States); Piedmonte, Marion R. [Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, NY (United States); Bundy, Brian [Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, NY (United States); Lentz, Samuel S. [Section on Gynecologic Oncology, Wake Forest University School of Medicine, Winston-Salem, NC (United States); Muderspach, Laila I. [Women's and Children's Hospital, Keck School of Medicine, University of Southern California, Los Angeles, CA (United States); Zaino, Richard J. [Department of Pathology, Milton S. Hershey Medical Center of Pennsylvania State University, Hershey, PA (United States)



Linking family characteristics with poor peer relations: The mediating role of conduct problems  

Microsoft Academic Search

Parent, teacher, and peer ratings were collected for 75 grade school boys to test the hypothesis that certain family interaction patterns would be associated with poor peer relations. Path analyses provided support for a mediational model, in which punitive and ineffective discipline was related to child conduct problems in home and school settings which, in turn, predicted poor peer relations.

Karen Linn Bierman; David L. Smoot



Physical Characteristics of the RR Lyrae Stars in the Very Metal Poor Globular Cluster NGC 5053  

NASA Astrophysics Data System (ADS)

The physical characteristics of the 10 RR Lyrae stars in the very metal-poor globular cluster NGC 5053 are derived from photometry of ~1000 B and V CCD frames acquired from 1994 to 2002 with the Dominion Astrophysical Observatory 1.8 m Plaskett Telescope. Revised pulsation periods and light curves, mean magnitudes, colors, amplitudes, and Fourier parameters are presented. Periods accurate to <~10-5 days are now known for all 10 RR Lyrae stars. Using times of maximum light dating back to Baade's original 1923-1927 observations, period change rates, dP/dt, accurate to <~0.07 days Myr-1, have been derived for the 10 stars. Seven stars have increasing periods, and three have decreasing periods, with the estimated period change rates for V1, V2, V9, and V10 being very close to zero. The mean dP/dt is equal to 0.04+/-0.04 days Myr-1 and is consistent with Lee's evolutionary model predictions for a cluster with horizontal-branch type ~0.5. Mean B - V colors range from 0.20 to 0.40 and are more consistent with near-zero reddening than alternative higher estimates. A reddening EB-V=0.018+/-0.003 is derived from the 1998 SFD maps. Mean effective temperatures vary from 6040 K (V10) to 7290 K (V6), with 2.6<=logg<=3.1. Visual and bolometric absolute magnitudes, bolometric corrections, and luminosities are derived using Fourier methods and using intensity- and magnitude-averaged mean magnitudes. Mean locations of the stars in the H-R diagram tend to progress from hotter, lower L stars to cooler, higher L stars and are consistent with theoretical blue and red edges of the instability strip. Masses estimated assuming zero reddening and Dorman's oxygen-enhanced models range from 0.68 Msolar (V6) to 0.78 Msolar (V10) for the 10 stars. The mean metal abundance for NGC 5053 derived using the Jurcsik-Kovács method lies significantly higher than the range -2.3 to -2.6 dex determined using other, more well established methods. This finding supports recent suggestions that metallicities derived from Fourier-based [Fe/H] calibrations need to be revised downward by at least 0.3 dex for RR Lyrae stars with very low metal abundances.

Nemec, James M.



A prognostic score for patients with lower risk myelodysplastic syndrome  

Microsoft Academic Search

Current prognostic models for myelodysplastic syndromes (MDS) do not allow the identification of patients with lower risk disease and poor prognosis that may benefit from early therapeutic intervention. We evaluated the characteristics of 856 patients with low or intermediate-1 disease by the International Prognostic Scoring System. Mean follow-up was 19.6 months (range 1–262). Of these patients, 87 (10%) transformed to

G Garcia-Manero; J Shan; S Faderl; J Cortes; F Ravandi; G Borthakur; W G Wierda; S Pierce; E Estey; J Liu; X Huang; H Kantarjian



High levels of carbonic anhydrase IX in tumour tissue and plasma are biomarkers of poor prognostic in patients with non-small cell lung cancer  

Microsoft Academic Search

Background:Carbonic anhydrase IX (CAIX) is an enzyme upregulated by hypoxia during tumour development and progression. This study was conducted to assess if the expression of CAIX in tumour tissue and\\/or plasma can be a prognostic factor in patients with non-small cell lung cancer (NSCLC).Methods:Tissue microarrays containing 555 NSCLC tissue samples were generated for quantification of CAIX expression. The plasma level

M ?lie; N M Mazure; V Hofman; R E Ammadi; C Ortholan; C Bonnetaud; K Havet; N Venissac; B Mograbi; J Mouroux; J Pouysségur; P Hofman



Two-weekly dose-adjusted (DA)-EPOCH-like chemotherapy with high-dose dexamethasone plus rituximab (DA-EDOCH14-R) in poor-prognostic untreated diffuse large B-cell lymphoma.  


The activity and safety of two-weekly dose-adjusted (DA)-EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin)-like chemotherapy with high-dose dexamethasone plus rituximab (DA-EDOCH14-R) was explored in 20 patients with previously untreated poor prognosis diffuse large B-cell lymphoma (DLBCL). The main outcomes were compared with those of 27 poor-prognosis patients enrolled into a previous trial of 3-weekly DA-EPOCH-R. Toxicity was manageable and there were no therapy-related deaths. Three-year progression-free survival (PFS) was superior in the DA-EDOCH14-R group (95% vs. 74%, P = 0·08). Importantly, this improvement in PFS with the two-weekly DA-EDOCH14-R was particularly notable in patients with an age-adjusted International Prognostic Index of 3 (100% vs. 30%, P < 0·001). PMID:23228045

García-Suárez, Julio; Flores, Elena; Callejas, Marta; Arribas, Ignacio; Gil-Fernández, Juan-José; Olmedilla, Gabriel; Curto, Natalia; Guillén, Helga; Casco, Celia-Rosalva; Martín, Yolanda; Burgaleta, Carmen



Prognostic factors in diffuse malignant pleural mesothelioma: effects of pretreatment clinical and laboratory characteristics  

Microsoft Academic Search

The aim of this study was to investigate the effects of various pretreatment clinical and laboratory characteristics on the survival of patients with diffuse malignant pleural mesothelioma (DMPM). One hundred histopathologically confirmed DMPM patients were evaluated. Fifty-nine were treated with chemoimmunotherapy, while 41 who had refused chemoimmunotherapy received supportive therapy alone. The following pretreatment characteristics were evaluated in both univariate




Secondary Intention Healing after Excision of Nonmelanoma Skin Cancer of the Head and Neck: Statistical Evaluation of Prognostic Values of Wound Characteristics and Final Cosmetic Results  

Microsoft Academic Search

Background: Most data on secondary intention healing of skin cancer defects in the head and neck are empirical and descriptive. This study statistically evaluates the prognostic value of several wound characteristics and location on the final cosmetic result of skin defects left to heal by secondary intention after tumor removal. Methods: A chart review of all facial reconstructions using secondary

Paul A. van der Eerden; Peter J. F. M. Lohuis; A. A. M. Hart; W. C. Mulder; Hade Vuyk



Collected Papers on Poverty Issues. Volume 3: Public Attitude Toward Poverty and the Characteristics of the Poor and the Near Poor.  

ERIC Educational Resources Information Center

|Volume 3 of a four volume collection, this document addresses the extent and the depth of public support in America for domestic social welfare programs and the social, moral, and economic attitudes of the poor and near poor. Specifically, three major sections focus on: the national morale and support for domestic reform; attitudes toward…

Yokelson, Doris, Ed.


Secreted protein, acidic and rich in cysteine-like 1 (SPARCL1) is down regulated in aggressive prostate cancers and is prognostic for poor clinical outcome  

PubMed Central

Prostate cancer is the second leading cause of cancer death among United States men. However, disease aggressiveness is varied, with low-grade disease often being indolent and high-grade cancer accounting for the greatest density of deaths. Outcomes are also disparate among men with high-grade prostate cancer, with upwards of 65% having disease recurrence even after primary treatment. Identification of men at risk for recurrence and elucidation of the molecular processes that drive their disease is paramount, as these men are the most likely to benefit from multimodal therapy. We previously showed that androgen-induced expression profiles in prostate development are reactivated in aggressive prostate cancers. Herein, we report the down-regulation of one such gene, Sparcl1, a secreted protein, acidic and rich in cysteine (SPARC) family matricellular protein, during invasive phases of prostate development and regeneration. We further demonstrate a parallel process in prostate cancer, with decreased expression of SPARCL1 in high-grade/metastatic prostate cancer. Mechanistically, we demonstrate that SPARCL1 loss increases the migratory and invasive properties of prostate cancer cells through Ras homolog gene family, member C (RHOC), a known mediator of metastatic progression. By using models incorporating clinicopathologic parameters to predict prostate cancer recurrence after treatment, we show that SPARCL1 loss is a significant, independent prognostic marker of disease progression. Thus, SPARCL1 is a potent regulator of cell migration/invasion and its loss is independently associated with prostate cancer recurrence.

Hurley, Paula J.; Marchionni, Luigi; Simons, Brian W.; Ross, Ashley E.; Peskoe, Sarah B.; Miller, Rebecca M.; Erho, Nicholas; Vergara, Ismael A.; Ghadessi, Mercedeh; Huang, Zhenhua; Gurel, Bora; Park, Ben Ho; Davicioni, Elai; Jenkins, Robert B.; Platz, Elizabeth A.; Berman, David M.; Schaeffer, Edward M.



Ophthalmologic and intraocular non-Hodgkin's lymphoma: a large single centre study of initial characteristics, natural history, and prognostic factors.  


The aims of this study were to define the initial characteristics, natural history, and prognostic factors of patients with ophthalmologic and intraocular malignant lymphoma. All patients treated at the Institut Curie for lymphoma with ophthalmologic (orbit and/or adnexa) or intraocular involvement were retrospectively reviewed. A pathological review of all cases was performed according to the WHO classification. One hundred and forty-five patients were selected for the study. Pathological review showed 36% MALT type lymphoma, 22% lymphoplasmocytic lymphoma, and 15% diffuse large B-cell lymphoma. Ophthalmologic and ocular sites were intra-orbital in 61 cases (42%) and conjunctival in 51 cases (35%), with bilateral involvement in 10% of cases. Stage IV was found in 32% of cases, with bone marrow involvement in 12%. With a median follow-up of 90 months, the 5-year DFS and OS were 64 and 79% for low-grade NHL, and 43 and 50% for high-grade NHL. On multivariate analysis, age greater than 59 years, elevated LDH level, stage IV, high-grade histological subgroup, and presence of B-symptoms had a negative impact on OS for the overall population. In conclusion, with a median follow-up of 7.5 years, our large cohort of patients represents one of the largest published series on primary ophthalmologic and intraocular malignant lymphoma. PMID:16134191

Meunier, Jérôme; Lumbroso-Le Rouic, Livia; Vincent-Salomon, Anne; Dendale, Rémy; Asselain, Bernard; Arnaud, Philippe; Fourquet, Alain; Desjardins, Laurence; Plancher, Corine; Validire, Patricia; Chaoui, Driss; Lévy, Christine; Decaudin, Didier



Overexpression of the EZH2, RING1 and BMI1 genes is common in myelodysplastic syndromes: relation to adverse epigenetic alteration and poor prognostic scoring  

Microsoft Academic Search

Epigenetics refers to the study of clonally inherited changes in gene expression without accompanying genetic changes. Previous\\u000a research on the epigenetics of myelodysplastic syndromes (MDS) mainly focused on the inactivation of tumor suppressor genes\\u000a as a result of DNA methylation. However, the basic molecular pathogenesis of epigenetics in MDS remains poorly understood.\\u000a Recent studies have revealed that DNA methylation and

Feng Xu; Xiao Li; Lingyun Wu; Qingxia Zhang; Rui Yang; Yujuan Yang; Zheng Zhang; Qi He; Chunkang Chang



Clinical characteristics and prognostic analysis of recurrent hemangiopericytoma in the central nervous system: a review of 46 cases.  


Central nervous system hemangiopericytoma (HPC) is a malignant vascularized mesenchymal tumor with a high rate of recurrence. Because of its rarity, few clinical characteristics and prognostic analysis information regarding recurrent HPC exist for doctors to pursue optimal outcomes. Forty-six recurrent HPC cases treated at our hospital between 2004 and 2012 were compiled into a single database based on a retrospective review of patient records, which were used to summarize the clinical characteristics. The mean survival of the recurrent HPC patients in our cohort was 41.6 ± 4.4 months, with 1-, 2-, 3-, and 4-year survival rates of 80.4, 65.2, 59.2, and 53.8 %, respectively. Thirty patients (65.2 %) suffered their first tumor recurrence, with a mean survival of 36.9 ± 4.1 months. Sixteen patients (34.8 %) suffered a second or further tumor recurrence, with a mean survival of 39.7 ± 7.0 months. Eighteen patients (39.1 %) died of all causes during the follow-up period, with a mean survival of 14.2 ± 5.6 months. Univariate and multivariate regression analyses showed that factors associated with good prognosis included recurrence age over 35 years, an interval between the first and second recurrence of more than 1 year and a clear boundary of the recurrent tumor. Gross total resection with adjuvant external beam radiotherapy could independently delay tumor recurrence of the second or more times and prolong the postoperative survival; thus, this strategy should be pursued as the initial treatment. PMID:23824534

Tian, Runfa; Hao, Shuyu; Hou, Zonggang; Bian, Liheng; Zhang, Ying; Wu, Weichuan; Xu, Feifan; Li, Huan; Liu, Baiyun



[Clinical characteristics of CD56(+) patients with acute monocytic leukemia and their prognostic significance].  


This study was aimed to investigate the clinical features of CD56(+) patients with acute monocytic leukemia (AML-M5) and their prognositic significance. The data of 76 newly-diagnosed patients from our hospital were analyzed retrospetively. Patients were divided into two groups: CD56(+) group (21 patients) and CD56(-) group (55 patients). The clinical features, CR rate, relapse rate, the duration of CR, and survival time of patients between the two groups were compared. The results indicated that the CD56(+) antigen was observed in 21 patients (27.6%), their median age was 51.5 years and with a range 16 - 70 years. Of the 21 CD56(+) patients, the high WBC count was found in 57.1% CD56(+) patients (12/21), but it only in 15% CD56(-) patients (P < 0.05). The extramedullary infiltrantion was seen in 13 CD56(+) patients, and accounted for 62% (13/21), meanwhile this infiltrantion was found in 18 CD56(-) patients (18/55) and accounted for 33% (P < 0.05). All cases immunophenotypically highly expressed CD13, CD33, CD64, CD11b, cMPO, CD38, in which only the expression frequency of CD11b was positively related with CD56 (r = 0.59, P < 0.05). The CR rate in CD56(+) group accounted for 60.0%, and had no significant difference in comparision with that in CD56(-) group. In CD56(+) group the relapse rate was 75% (P = 0.042), the mean duration of CR was 5.5 months (95%CI, 3.1 - 8.6, P = 0.002), the median overall survival time was 10.1 months (95%CI, 2.3 - 16.3, P = 0.001). and all these had statistical significance as compared with that in CD56(-) group. It is concluded that CD56(+) AML-M5 patients always complicate with high WBC count and extramedullary infiltration, their CR rate and duration of CR are lower and shorter respectively, their relaps rate and prognosis are high and poor respectively. PMID:23815905

Yang, Lin-Lin; Gan, Si-Lin; Liu, Yan-Fang; Zhang, Qiu-Tang; Li, Tao; Ma, Jie; Sun, Hui



High density of tryptase-positive mast cells in human colorectal cancer: a poor prognostic factor related to protease-activated receptor 2 expression  

PubMed Central

Tryptase(+) mast cells (MCs), abundant in the invasive front of tumours, contribute to tissue remodelling. Indeed, protease-activated receptor-2 (PAR-2) activation by MC-tryptase is considered an oncogenic event in colorectal cancer (CRC). Recently, we have suggested NHERF1 as a potential new marker in CRC. In this study, we aimed to determine the distribution of tryptase(+) MCs and PAR-2 and to examine the relationship between PAR-2 and NHERF1, investigating their reputed usefulness as tumour markers. We studied a cohort of 115 CRC specimens including primary cancer (C) and adjacent normal mucosa (NM) by immunohistochemical double staining, analyzing the protein expression of MC-tryptase, PAR-2 and cytoplasmic NHERF1. MC density was higher in NM than in C. Tumours with high TNM stage and poor grade showed the highest MC density. A higher PAR-2 immunoreactivity characterized tumours most infiltrated by MCs compared with samples with low MC density. Furthermore, PAR-2 overexpression was associated with advanced TNM stage, poor grade and lymphovascular invasion (LVI). A positive correlation existed between tryptase(+) MC density and PAR-2 expression. Cytoplasmic NHERF1 was higher in C than in NM and overexpressing tumours resulted associated with nodal and distant metastases, poor grade and LVI. PAR-2 correlated with cytoplasmic NHERF1 and the PAR-2(+)/cytoplasmic NHERF1(+) expression immunophenotype identified tumours associated with unfavourable prognosis and aggressive clinical parameters. Our data indicate that the high density of tryptase(+) MCs at invasive margins of tumours was associated with advanced stages of CRC and was strongly correlated with PAR-2 expression.

Malfettone, Andrea; Silvestris, Nicola; Saponaro, Concetta; Ranieri, Girolamo; Russo, Antonio; Caruso, Stefano; Popescu, Ondina; Simone, Giovanni; Paradiso, Angelo; Mangia, Anita



High density of tryptase-positive mast cells in human colorectal cancer: a poor prognostic factor related to protease-activated receptor 2 expression.  


Tryptase(+) mast cells (MCs), abundant in the invasive front of tumours, contribute to tissue remodelling. Indeed, protease-activated receptor-2 (PAR-2) activation by MC-tryptase is considered an oncogenic event in colorectal cancer (CRC). Recently, we have suggested NHERF1 as a potential new marker in CRC. In this study, we aimed to determine the distribution of tryptase(+) MCs and PAR-2 and to examine the relationship between PAR-2 and NHERF1, investigating their reputed usefulness as tumour markers. We studied a cohort of 115 CRC specimens including primary cancer (C) and adjacent normal mucosa (NM) by immunohistochemical double staining, analyzing the protein expression of MC-tryptase, PAR-2 and cytoplasmic NHERF1. MC density was higher in NM than in C. Tumours with high TNM stage and poor grade showed the highest MC density. A higher PAR-2 immunoreactivity characterized tumours most infiltrated by MCs compared with samples with low MC density. Furthermore, PAR-2 overexpression was associated with advanced TNM stage, poor grade and lymphovascular invasion (LVI). A positive correlation existed between tryptase(+) MC density and PAR-2 expression. Cytoplasmic NHERF1 was higher in C than in NM and overexpressing tumours resulted associated with nodal and distant metastases, poor grade and LVI. PAR-2 correlated with cytoplasmic NHERF1 and the PAR-2(+)/cytoplasmic NHERF1(+) expression immunophenotype identified tumours associated with unfavourable prognosis and aggressive clinical parameters. Our data indicate that the high density of tryptase(+) MCs at invasive margins of tumours was associated with advanced stages of CRC and was strongly correlated with PAR-2 expression. PMID:23991686

Malfettone, Andrea; Silvestris, Nicola; Saponaro, Concetta; Ranieri, Girolamo; Russo, Antonio; Caruso, Stefano; Popescu, Ondina; Simone, Giovanni; Paradiso, Angelo; Mangia, Anita



[Poor prognostic value of weight change during chemotherapy in non-metastatic breast cancer patients: causes, mechanisms involved and preventive strategies].  


Numerous studies have demonstrated that a significant change in weight during chemotherapy treatment was a factor of poor prognosis in early breast cancer women. However, the causes and mechanisms involved in this phenomenon are not fully known. This review summarizes current knowledge about the causes of energy imbalance during chemotherapy treatment and the mechanisms that have been proposed as responsible for the increased risk of relapse and death in this population. Current preventive strategies focus on physical activity programs but also on the use of metformin during and after chemotherapy. PMID:24045219

Gadéa, Émilie; Thivat, Émilie; Wang-Lopez, Qian; Viala, Marie; Paulon, Rodolphe; Planchat, Éloïse; Chadeyras, Jean-Baptiste; Merlin, Charles; Coudert, Bruno; Bignon, Yves-Jean; Morio, Béatrice; Durando, Xavier





PURPOSE:: To describe characteristics and outcomes of fall-related open globe (OG) injuries. METHODS:: A total of 602 patients (603 eyes) presenting with OG injuries were included. Among them, 85 wounds (85 patients) were fall-related, which were compared with the nonfall-related OG injuries (control group). RESULTS:: The mean patient age in the fall group was 65.8 years, which was higher than the control population (35.8 years; P < 0.001). Most of the fall-related injuries occurred in women (58.8%). The most common zone injured in both groups was Zone I (38.8% and 46% in the fall and control group, respectively). Compared with the control group, patients with fall-related OG injuries had a worse visual acuity on admission and at final visit (P < 0.001). The authors performed regression analysis to characterize factors associated with developing no light perception and need for enucleation. Injuries involving Zone III and presenting vision of no light perception were associated with a higher rate of no light perception. Similarly, patients presenting with no light perception were more likely to undergo enucleation, eventually. CONCLUSION:: Fall-related OG injuries can lead to severe ocular morbidity especially in the elderly patients. They carry a worse visual prognosis compared with other injuries, which emphasizes on the importance of protective measures in this population. PMID:23609126

Emami-Naeini, Parisa; Ragam, Ashwinee; Bauza, Alain M; Soni, Nishant; Langer, Paul; Zarbin, Marco A; Bhagat, Neelakshi



Molecular characteristics and prognostic features of breast cancer in Nigerian compared with UK women.  


Although breast cancer (BC) incidence is lower in African-American women compared with White-American, in African countries such as Nigeria, BC is a common disease. Nigerian women have a higher risk for early-onset, with a high mortality rate from BC, prompting speculation that risk factors could be genetic and the molecular portrait of these tumours are different to those of western women. In this study, 308 BC samples from Nigerian women with complete clinical history and tumour characteristics were included and compared with a large series of BC from the UK as a control group. Immunoprofile of these tumours was characterised using a panel of 11 biomarkers of known relevance to BC. The immunoprofile and patients' outcome were compared with tumour grade-matched UK control group. Nigerian women presenting with BC were more frequently premenopausal, and their tumours were characterised by large primary tumour size, high tumour grade, advanced lymph node stage, and a higher rate of vascular invasion compared with UK women. In the grade-matched groups, Nigerian BC showed over representation of triple-negative and basal phenotypes and BRCA1 deficiency BC compared with UK women, but no difference was found regarding HER2 expression between the two series. Nigerian women showed significantly poorer outcome after development of BC compared with UK women. This study demonstrates that there are possible genetic and molecular differences between an indigenous Black population and a UK-based series. The basal-like, triple negative and BRCA1 dysfunction groups of tumours identified in this study may have implications in the development of screening programs and therapies for African patients and families that are likely to have a BRCA1 dysfunction, basal like and triple negative. PMID:22842985

Agboola, A J; Musa, A A; Wanangwa, N; Abdel-Fatah, T; Nolan, C C; Ayoade, B A; Oyebadejo, T Y; Banjo, A A; Deji-Agboola, A M; Rakha, E A; Green, A R; Ellis, I O



Molecular Profiling of Multiple Human Cancers Defines an Inflammatory Cancer-Associated Molecular Pattern and Uncovers KPNA2 as a Uniform Poor Prognostic Cancer Marker  

PubMed Central

Background Immune evasion is one of the recognized hallmarks of cancer. Inflammatory responses to cancer can also contribute directly to oncogenesis. Since the immune system is hardwired to protect the host, there is a possibility that cancers, regardless of their histological origins, endow themselves with a common and shared inflammatory cancer-associated molecular pattern (iCAMP) to promote oncoinflammation. However, the definition of iCAMP has not been conceptually and experimentally investigated. Methods and Findings Genome-wide cDNA expression data was analyzed for 221 normal and 324 cancer specimens from 7 cancer types: breast, prostate, lung, colon, gastric, oral and pancreatic. A total of 96 inflammatory genes with consistent dysregulation were identified, including 44 up-regulated and 52 down-regulated genes. Protein expression was confirmed by immunohistochemistry for some of these genes. The iCAMP contains proteins whose roles in cancer have been implicated and others which are yet to be appreciated. The clinical significance of many iCAMP genes was confirmed in multiple independent cohorts of colon and ovarian cancer patients. In both cases, better prognosis correlated strongly with high CXCL13 and low level of GREM1, LOX, TNFAIP6, CD36, and EDNRA. An “Inflammatory Gene Integrated Score” was further developed from the combination of 18 iCAMP genes in ovarian cancer, which predicted overall survival. Noticeably, as a selective nuclear import protein whose immuno-regulatory function just begins to emerge, karyopherin alpha 2 (KPNA2) is uniformly up-regulated across cancer types. For the first time, the cancer-specific up-regulation of KPNA2 and its clinical significance were verified by tissue microarray analysis in colon and head-neck cancers. Conclusion This work defines an inflammatory signature shared by seven epithelial cancer types and KPNA2 as a consistently up-regulated protein in cancer. Identification of iCAMP may not only serve as a novel biomarker for prognostication and individualized treatment of cancer, but also have significant biological implications.

Rachidi, Saleh M.; Qin, Tingting; Sun, Shaoli; Zheng, W. Jim; Li, Zihai



The t(14;20) is a poor prognostic factor in myeloma but is associated with long-term stable disease in monoclonal gammopathies of undetermined significance  

PubMed Central

A large series of plasma cell dyscrasias (n=2207) was examined for translocations which deregulate the MAF genes, t(14;20)(q32;q12) and t(14;16)(q32;q23), and their disease behavior was compared to a group characterized by the t(4;14)(p16;q32) where CCND2 is also up-regulated. The t(14;20) showed low prevalence in myeloma (27/1830, 1.5%) and smoldering myeloma (1/148, <1%) with a higher incidence in MGUS (9/193, 5% P=0.005). Strong associations with del(13) (76%), non-hyperdiploidy (83%) and gain of 1q (58%) were seen but no association with an IgA M-protein or absence of bone disease was noted. All three translocations were associated with poor outcome in myeloma, but strikingly all t(14;20) MGUS/smoldering myeloma cases (n=10) had stable, low level disease. In contrast, the 10 t(14;16) and 25 t(4;14) MGUS/smoldering myeloma cases were associated with both evolving and non-evolving disease. None of the associated genetic abnormalities helped to predict for progression from MGUS or smoldering myeloma. ( identifier: ISRCTN 68454111; UKCRN ID 1176)

Ross, Fiona M.; Chiecchio, Laura; Dagrada, GianPaolo; Protheroe, Rebecca K.M.; Stockley, David M.; Harrison, Christine J.; Cross, Nicholas C.P.; Szubert, Alex J.; Drayson, Mark T.; Morgan, Gareth J.



Stellar Abundances for the Galactic Archeology (SAGA) Database --- Compilation of the Characteristics of Known Extremely Metal-Poor Stars  

NASA Astrophysics Data System (ADS)

We describe the construction of a database of extremely metal-poor (EMP) stars in the Galaxy. Our database contains detailed elemental abundances, reported equivalent widths, atmospheric parameters, photometry, and binarity status, compiled from papers in the literature that report on studies of EMP halo stars with [Fe/H] ? -2.5. The compilation procedures for this database were designed to assemble data effectively from electronic tables available from online journals. We have also developed a data retrieval system that enables data searches by various criteria and illustrations to explore relationships between stored variables. Currently, our sample includes 1212 unique stars (many of which are studied by more than one group) with more than 15000 individual reported elemental abundances, covering relevant papers published by 2007 December. We discuss the global characteristics of the present database, as revealed by the EMP stars observed to date. For stars with [Fe/H] ? -2.5, the number of giants with reported abundances is larger than that of dwarfs by a factor of two. The fraction of carbon-rich stars (among the sample for which the carbon abundance is reported) amounts to ˜30% for [Fe/H] ? -2.5. We find that known binaries exhibit different distributions of the orbital period, according to whether they are giants or dwarfs, and also as a function of the metallicity, although the total sample of such stars is still quite small.

Suda, Takuma; Katsuta, Yutaka; Yamada, Shimako; Suwa, Tamon; Ishizuka, Chikako; Komiya, Yutaka; Sorai, Kazuo; Aikawa, Masayuki; Fujimoto, Masayuki Y.



A Study on Solubilization of Poorly Soluble Drugs by Cyclodextrins and Micelles: Complexation and Binding Characteristics of Sulfamethoxazole and Trimethoprim  

PubMed Central

The present study is focused on the characterization of solubilization of poorly soluble drugs, that is, sulfamethoxazole (SMX) and trimethoprim (TMP) by cyclodextrins (?-, ?-, and ?-CDs) and anionic surfactant sodium dodecyl sulfate (SDS). The phase solubility diagrams drawn from UV spectral measurements are of the AL type and indicate an enhancement of SMX and TMP solubility in the presence of CDs. Complex formation tendency of TMP with CDs followed the order: ?-CD > ?-CD > ?-C. However, the complex formation constant values, for SMX-CD system yielded the different affinity and follow the order: ?-CD > ?-CD > ?-CD. With taking into consideration of solubilization capacity of SDS micelles, it has been found that the solubility enhancement of TMP is much higher than that of SMX in the presence of SDS micelles. The binding constants of SMX and TMP obtained from the Benesi-Hildebrand equation are also confirmed by the estimated surface properties of SDS, employing the surface tension measurements. In order to elucidate the solubilization characteristics the surface tension measurements were also performed for nonionic surfactant Triton X-100. Polarity of the microenvironment and probable location of SMX and TMP were also discussed in the presence of various organic solvents.

Gokturk, Sinem; Cal?skan, Elif; Talman, R. Yesim; Var, Umran



Expression characteristics of astrocyte elevated gene-1 (AEG-1) in tongue carcinoma and its correlation with poor prognosis.  


Astrocyte elevated gene-1 (AEG-1) expression is increased in diverse human cancers and plays a vital role in tumorigenesis and progression. The aim of this study was to investigate the clinicopathologic features and prognostic significance of AEG-1 in squamous cell carcinoma of the tongue (TSCC). Immunohistochemistry (IHC) was performed to examine AEG-1 protein expression in paraffin-embedded tissues from 93 patients with TSCC. Real-time PCR and western blot analyses were employed to examine AEG-1 expression in 4 pairs of primary TSCC and adjacent non-cancerous tissues from the same patient. Immunohistochemical results revealed that the positive rate for AEG-1 in TSCC tissues (48.39%, 45/93) was higher than that in the normal tongue tissues (10.00%, 3/30) (P < 0.001). These results were further confirmed between TSCC tissues and matched adjacent non-cancerous tissues by Western blot and RT-PCR. Simultaneously, AEG-1 protein level was positively correlated with differentiation degree (P < 0.001), clinical stage (P < 0.001), T classification (P = 0.007) and N classification (P = 0.012). Furthermore, patients with higher AEG-1 expression had shorter overall survival time. Multivariate analysis (Cox regression) also suggested that AEG-1 expression was an independent prognostic indicator for TSCC (P = 0.043). Our results indicate that AEG-1 expression is closely associated with carcinogenesis and progression of TSCC, and may represent a novel and valuable predictor for prognostic evaluation of TSCC patients. PMID:23142337

Ke, Zun-Fu; He, Shanyang; Li, Shuhua; Luo, Dongyuan; Feng, Chongjin; Zhou, Wenwen



Immunohistochemical expression of cyclins, cyclin-dependent kinases, tumor-suppressor gene products, Ki-67, and sex steroid receptors in endometrial carcinoma: positive staining for cyclin A as a poor prognostic indicator.  


Although aberrant expression of several cell-cycle regulators has been reported in endometrial carcinoma, correlations among these factors and their prognostic significance have not fully been elucidated. In the present study, expression of cyclins (D1, E, A, and B1), cyclin-dependent kinases (cdk2, cdk4, and cdc2), and tumor-suppressor gene products (p53, p21, and p27) were systematically examined by immunohistochemistry in 82 cases of endometrial carcinoma and 20 normal endometria. Results were compared with the expression of Ki-67, sex steroid receptor status, clinicopathological parameters, and patient outcomes. Positive staining for cyclin D1, cyclin E, cyclin A, cyclin B1, cdk2, cdk4, cdc2, p53, p21, and p27 was observed in 63%, 66%, 31%, 32%, 51%, 77%, 71%, 43%, 35%, and 60% of the 82 carcinomas, respectively. Among these factors, positive staining for cyclin D1, cdk4, and p53 was significantly frequent in advanced-stage tumors, and that for cyclin D1, cyclin A, cdk4, p21, and p53 was more frequent in higher-grade tumors. High correlation was found between cyclin A and p53 expression, between cyclin D1 and cdk4 expression, between cdk4 and Ki-67 expression, and between p21 and Ki-67 expression. Multivariate analysis showed that the factors for poor prognosis were advanced stage and cyclin A positivity. These findings suggest that various cell-cycle regulators are involved in activated cell growth of endometrial carcinoma, and that positive staining for cyclin A could be a useful marker for unfavorable patient prognosis. PMID:12792921

Shih, Hsien-Chang; Shiozawa, Tanri; Kato, Kiyoshi; Imai, Tsutomu; Miyamoto, Tsutomu; Uchikawa, Junko; Nikaido, Toshio; Konishi, Ikuo



Evaluation of bovine zona pellucida characteristics in polarized light as a prognostic marker for embryonic developmental potential.  


It has previously been demonstrated that zona pellucida imaging of human oocytes using polarized light microscopy is a clinically applicable method for the noninvasive assessment of oocyte quality. This study was designed to investigate whether zona pellucida characteristics of bovine oocytes and zygotes in polarized light may similarly serve as a useful marker for developmental competence in bovine reproductive biotechnologies. Zona birefringence intensity parameters of 2862 oocytes/zygotes were objectively evaluated with an automatic analysis system and correlated with oocyte/zygote quality. In detail, immature oocytes of good quality assessed with brilliant cresyl blue staining showed significantly lower zona birefringence than poor-quality counterparts (P<0.001). After in vitro maturation and classification according to maturational status, the birefringence intensity parameters were significantly different in those oocytes that reached metaphase II compared with arrested stages (P<0.001). Following either parthenogenetic activation or IVF with subsequent in vitro culture in a well-of-the-well system until day 9, superior development as determined by cleavage, blastocyst formation, and hatching ability was associated with lower zona birefringence intensity parameters. When early zygote-stage embryos were selected and assorted in groups based on zona birefringence (high/medium/low), the group of embryos derived from high-birefringence zygotes displayed a significantly compromised developmental potential compared with low-birefringence zygotes. These results clearly show that developmentally competent bovine oocytes/zygotes exhibit lower zona birefringence intensity parameters. Therefore, birefringence imaging of zona pellucida is a suitable technique to predict bovine preimplantation embryo development. PMID:21415090

Koester, M; Mohammadi-Sangcheshmeh, A; Montag, M; Rings, F; Schimming, T; Tesfaye, D; Schellander, K; Hoelker, M



Prognostic value of histological grading in noninflammatory canine mammary carcinomas in a prospective study with two-year follow-up: relationship with clinical and histological characteristics.  


In this prospective study, a canine-adapted histological grading method was compared with histopathological and clinical characteristics and was evaluated as a prognostic indicator in canine mammary carcinomas (CMCs). Recruited dogs with at least 1 malignant mammary tumor (n = 65) were clinically evaluated, surgically treated, and followed up (minimum follow-up 28 months, maximum 38 months). Histopathological diagnoses were performed according to Goldschmidt et al (2011). Tumors were graded as grade I (29/65), grade II (19/65), and grade III (17/65). The tumor size, clinical stage, histological diagnosis, presence/absence of myoepithelial proliferation, and regional lymph node metastases at diagnosis were significantly associated with histological grade. The histological grade, age, clinical stage, tumor subtype group, and lymph node metastases at time of diagnosis were significantly associated with the development of recurrences and/or metastases, cancer-associated death, and survival times (disease-free survival and overall survival) in univariate analyses. A subdivision of clinical stage I (T1N0M0) into stages IA and IB was proposed in terms of prognosis. The clinical stage, histological grade, and spay status were selected as independent prognostic variables (multivariate analyses) with disease-free survival as the dependent variable. When overall survival was evaluated as a dependent variable, clinical stage and histological grade were selected as the independent covariates. This grading system is a useful prognostic tool, facilitates histological interpretation, and offers uniform criteria for veterinary pathologists. Comparative studies on CMCs performed in different countries should take into account possible changes in the prognoses due to different proportions of spayed females among the selected dog population. PMID:22688585

Peña, L; De Andrés, P J; Clemente, M; Cuesta, P; Pérez-Alenza, M D



Prognostic factors.  


The best predictive models of today can predict no more than 50% of the natural variability of the disease, despite the sophisticated mathematic analyses and the dozens of variables assessed. Clearly, a universe of still unknown prognostic factors remains to be discovered. Analogous to infinity being immeasurable, the fate of the individual patient will never be calculated mathematically. As the discovery of new prognostic factors continues, however, the prediction of the outcome of patients becomes more reliable. Although some prognostic factors (eg, tumor neoangiogenesis and quality of life) are already supported by a large body of evidence, recent research has introduced new groups of prognostic factors (eg, molecular genetic markers and the subclinical activation of coagulation fibrinolysis). Other intriguing factors (eg, a state of mental depression) might also be recognized as important in the near future. A new small portion of the universe has been explored. PMID:15005288

Buccheri, Gianfranco; Ferrigno, Domenico



The small child: anthropometric and physical performance characteristics of short-for-age children growing in good and in poor socio-economic conditions  

Microsoft Academic Search

Objective: To ascertain whether individuals whose short stature is caused by poor living conditions differ in their other biological characteristics from those individuals who grow short, supposedly due to their genetic endowment, under favourable environmental conditions.Design: From the growth survey of nearly 4000 children of the ‘Cape Coloured’ community aged 6–18 y half of whom lived in the middle-class suburbs

M Henneberg; GA Harrison; G Brush



Femorofemoral bypass: prognostic factors.  


During a 17-year period, femorofemoral bypass grafting was performed on 85 patients as the primary operation for unilateral iliac artery disease. Of these patients, 53 (62%) were operated on for claudication and 32 (38%) for limb salvage. There were two operative deaths (2.4%). The 5-year cumulative graft patency rate was 63.2%, and the limb salvage rate was 70%. Prognostic factors included poor runoff and distal disease, donor iliac artery stenosis prior to femorofemoral bypass grafting, and progression of disease in the donor vessel following surgery. Definitive surgical correction is safe and effective with good long-term results. PMID:15227107

Subram, A N; Urrutia-S, C O; Ott, D A; Cooley, D A



Femorofemoral Bypass: Prognostic Factors  

PubMed Central

During a 17-year period, femorofemoral bypass grafting was performed on 85 patients as the primary operation for unilateral iliac artery disease. Of these patients, 53 (62%) were operated on for claudication and 32 (38%) for limb salvage. There were two operative deaths (2.4%). The 5-year cumulative graft patency rate was 63.2%, and the limb salvage rate was 70%. Prognostic factors included poor runoff and distal disease, donor iliac artery stenosis prior to femorofemoral bypass grafting, and progression of disease in the donor vessel following surgery. Definitive surgical correction is safe and effective with good long-term results.

Subram, Aswath N.; Urrutia-S, Carlos O.; Ott, David A.; Cooley, Denton A.




PubMed Central

SUMMARY This study examined the relationship between measures of outcome and socio-demographic arid diagnostic variables in schizophrenia. Product moment co-efficient of correlation and stepwise multiple regression were the main statistical techniques of analyses. The results of the study indicate that DSM-III diagnosis of schizophrenia, duration of illness, and Present State Examination-PSE Syndrome of non-specific psychosis are important predictors of outcome. CATEGO and Research Diagnostic Criteria-RDC diagnosis of Schizophrenia, and Schneiderian First Rank Symptoms were found to be poor predictors of outcome. Socio-demographic and clinical variables like gender of the patient, place of origin, impersistence at work, poor premorbid work record, hospitalization at the time of admittance into the study, loss of interest, affective flattening and incoherent speech were found to have prognostic implications.

Kulhara, P.; Avasthi, A.; Chandiramani, K.



The characteristics of short- and long-term surviving Shiba dogs with chronic enteropathies and the risk factors for poor outcome  

PubMed Central

Background The objectives of this study were to investigate the differences in the characteristics of short- and long-term surviving dogs, and the factors that predict poor outcome in Shiba dogs with chronic enteropathies (CE). Methods A total of 25 Shiba dogs were included in this study, and classified as either short-term (?6 months) survivors (Ss; n=16) or long-term (>6 months) survivors (Ls; n=9). The clinical and clinicopathological variables, histopathology, response to therapy, and outcomes were investigated between groups. Furthermore, these factors were tested for their ability to predict poor outcome. Results All CE dogs were diagnosed as having inflammatory bowel disease (IBD) with lymphocytic-plasmacytic enteritis (LPE). Age and canine inflammatory bowel disease activity index (CIBDAI) were significantly higher in the Ss group than in the Ls group (age: p = 0.035, CIBDAI: p = 0.018), as determined via univariate logistic regression analysis. According to receiver operator characteristic (ROC) curve analysis, the best predictors of poor outcome were age and CIBDAI, with the cutoffs determined as 7 years and 9 points, respectively. The majority of the cases (84%) responded to initial treatment; in particular, 75% of dogs in Ss group responded to therapy. The time to response (days) to the initial treatment in the Ss group (median 42.5 days, range: 20-91 days) was significantly shorter than that of the Ls group (median 285 days, range: 196-1026 days). Approximately half (55.5%) of the dogs in the Ls group died due to relapse of CE. Conclusions This study suggested that there is a high risk of early mortality in Shiba dogs with CE, particularly if the dogs are older (>7 years) and have a high CIBDAI score (>9 points). There appears to be a possibility of early mortality even if the initial treatment was efficacious. Furthermore, Shiba dogs with CE that become less responsive to initial therapy in the short-term (approximately 3 months) are more likely to have an early mortality. Thus, it is necessary to follow-up Shiba dogs with CE in the long-term, as approximately half of the long-term survivors eventually died due to a relapse of the signs.



The interaction between prognostic and pharmacodynamic biomarkers.  


Background:Interactions between prognostic and pharmacodynamic (PD) biomarkers have received little attention.Methods:Prognostic and PD utilities were assessed with linear mixed-effects models using published data on repeated measurements of circulating caspase-cleaved (ctCK18) and total (tCK18) cytokeratin 18, in 57 patients with metastatic colorectal cancer undergoing chemotherapy.Results:The model for tCK18 (but not cCK18) separated the prognostic/PD interaction from the pure prognostic effect, illustrating the principle of dual prognostic and PD characteristics for a given biomarker.Conclusion:These models provide the framework for the analysis and interpretation of longitudinal data to detect prognostic/PD biomarker interactions. PMID:24002599

Bouranis, L; Sperrin, M; Greystoke, A; Dive, C; Renehan, A G



Clinical characteristics of Merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features  

Microsoft Academic Search

Background: Merkel cell carcinoma (MCC) is an aggressive skin cancer with a mortality of 33%. Advanced disease at diagnosis is a poor prognostic factor, suggesting that earlier detection may improve outcome. No systematic analysis has been published to define the clinical features that are characteristic of MCC. Objective: We sought to define the clinical characteristics present at diagnosis to identify

Michelle Heath; Natalia Jaimes; Bianca Lemos; Arash Mostaghimi; Linda C. Wang; Pablo F. Penas; Paul Nghiem


[Prognostic factors uterine corpus cancer].  


The accumulated clinico-pathological dates and recent molecular biological studies have identified several prognostic factors for endometrial cancers. FIGO staging has taken into consideration of the tumor expansion and is the most important predictor in evaluating patient outcome. Characteristics of tumor biology, such as morphology of tumor and depth of invasion are also important prognostic considerations. Molecular markers indicating genetic/molecular events in cancer biology appear to be the 3rd predictors in estimating the prognosis. Finally, treatment of uterine corpus cancer can be directly related to prognosis. Postoperative chemotherapy is gradually taking precedence over irradiation in considering evidence-based medicine. PMID:17197744

Inoue, Masaki



Prognostic factors for peritonitis outcome.  


Despite advances in treatment and prevention, peritonitis remains a major problem in peritoneal dialysis (PD) patients with often technique failure as a consequence. The last decades the focus of PD peritonitis has changed from lowering peritonitis incidence to improvement of peritonitis outcome. Prognostic factors for peritonitis outcome can influence decision making during the treatment of peritonitis, for example to take out the PD catheter early in the time course of peritonitis and prevent further damage to the peritoneal membrane. In this paper, we give a review of the literature about prognostic factors for peritonitis outcome. In most studies, age, gender, diabetes, time on PD, a precursor of calcitonin:procalcitonin, IL-6 and albumin did not show a significant effect on peritonitis outcome. The following factors have been associated with poor outcome of peritonitis: Gram-negative organisms, Mycobacterium species, fungal peritonitis, polymicrobial peritonitis, concurrent exit site or tunnel infection, Caucasian race, low residual GFR, persistently elevated peritoneal dialysate white cell count, CRP, and low levels of slCAM-1 and hyaluronan at the end of peritonitis treatment. In fungal peritonitis, abdominal pain, bowel obstruction, the catheter remaining in situ and Candidaparapsilosis are factors associated with higher mortality rate and a greater risk of technique failure. Recent antibiotic therapy and peritonitis are associated with poor treatment response in culture-negative peritonitis. Recurrent peritonitis episodes have a poor therapeutic response and high mortality and have a worse prognosis than relapsing ones. Older age, long PD duration and continuous elevated serum CRP levels are predictors of adverse outcomes in PD patients after peritonitis-related catheter removal. Peritonitis remains a serious complication of PD with marked morbidity. It is a common cause of technique failure. The rate of PD-related peritonitis has decreased over the last decades due to advances in treatment and prevention. Nowadays, the focus moved from lowering peritonitis incidence towards improving peritonitis outcome. It is useful to have prognostic factors for peritonitis outcome, because they can influence decision-making during the treatment of peritonitis, for example to take out the PD catheter early in the time course of peritonitis and prevent further damage to the peritoneal membrane. In the last decades, many publications appeared about prognostic factors for peritonitis outcome. This article summarizes those prognostic factors, based on an extensive review of the literature. PMID:22652748

van Esch, Sadie; Krediet, Raymond T; Struijk, Dirk G



Prognostication after cardiac arrest.  


The best predictor of good outcome after cardiac arrest is awakening from coma. The longer it takes to regain consciousness, the greater the risk of permanent brain injury. A reliable neurological assessment could previously be performed on day 3 after arrest; absence of or a stereotypic motor reaction to pain and absence of cranial nerve reflexes were reliable predictors of poor outcome, but this has changed. The introduction of therapeutic hypothermia and concurrent sedation and muscle relaxation has affected the reliability of the clinical investigation. This is probably due to increased use of sedative drugs and delayed metabolism during hypothermia but could, in addition, be explained by delayed maturation and recovery processes of brain ischaemia. A clinical neurological assessment should no longer be the sole decisive method for prognostication after cardiac arrest. Instead, a clinical investigation should be used in combination with independent and objective methods, above all neurophysiology (electroencephalography and somatosensory evoked potentials), while biomarkers and brain imaging may be valuable adjuncts. PMID:24054514

Friberg, Hans; Cronberg, Tobias



Low cyclin F expression in hepatocellular carcinoma associates with poor differentiation and unfavorable prognosis.  


Cyclin F, capable of forming Skp1-Cul1-F-box protein ubiquitin ligase complex, is implicated in controlling centrosome duplication and preventing genome instability. Cyclin F oscillates during cell cycle with a similar pattern to cyclin A. However, its expression and significance in cancer remain obscure. In this study, we showed that cyclin F was noticeably decreased in 16 pairs of tissue samples of hepatocellular carcinoma (HCC) compared to paracarcinoma tissues, at both mRNA and protein levels. Immunohistochemical staining data revealed that in 71.8% (176/245) of HCC cases, cyclin F expression in tumor tissue was much lower than that in nontumorous tissue. Low cyclin F expression, defined by receiver operating characteristic curve analysis, was present in 69.0% of HCC patients. Low expression of cyclin F was significantly correlated with tumor size, clinical stage, serum alpha-fetoprotein level and tumor multiplicity. Further study showed that cyclin F expression was reversely associated with tumor differentiation in HCC. Kaplan-Meier analysis indicated that low cyclin F expression was related to poor overall survival and recurrence-free survival. The prognostic impact of cyclin F was further confirmed by stratified survival analysis. Importantly, multivariate analysis revealed that low cyclin F expression was an independent poor prognostic marker for overall survival. We conclude that cyclin F is downregulated in HCC and is a promising prognostic marker for patients suffering from this deadly disease. PMID:23305207

Fu, Jia; Qiu, Huijuan; Cai, Muyan; Pan, Yinghua; Cao, Yun; Liu, Lili; Yun, Jingping; Zhang, Chris Zhiyi



A new prognostic classification for overall survival in Asian patients with previously untreated metastatic renal cell carcinoma.  


The aims of the present study were to: (i) develop a clinically useful prognostic classification in Asian patients with metastatic renal cell carcinoma (RCC) by combining metastatic features with several pretreatment parameters; and (ii) evaluate the validity of this prognostic classification. Baseline characteristics and outcomes were collected for 361 patients who underwent interferon-?-based therapy between 1995 and 2005. Relationships between overall survival (OS) and potential prognostic factors were assessed using Cox's proportional hazard model. The predictive performance of the model was evaluated using bootstrap resampling procedures and by using an independent dataset obtained from randomly selected institutions. The predictive accuracy was measured using the concordance index (c-index). Four factors were identified as independent prognostic factors: time from initial diagnosis to treatment, anemia, elevated lactate dehydrogenase (LDH), and poor prognostic metastatic group (liver only, bone only, or multiple organ metastases). Each patient was assigned to one of three risk groups: favorable risk (none or one factor; n = 120), in which median OS was 51 months; intermediate risk (two factors; n = 101), in which median OS was 21 months; and poor risk (three or four factors; n = 102), in which median OS was 10 months. The c-index was 0.72 in the original dataset and 0.72 in 500 random bootstrap samples. In the independent dataset for external validation, the c-index was 0.73. Thus, the new prognostic classification is easily applicable for Asian patients with previously untreated metastatic RCC and should be incorporated into patient care, as well as clinical trials performed in Asia. PMID:22642767

Shinohara, Nobuo; Nonomura, Katsuya; Abe, Takashige; Maruyama, Satoru; Kamai, Takao; Takahashi, Masayuki; Tatsugami, Katsunori; Yokoi, Shigeaki; Deguchi, Takashi; Kanayama, Hiroomi; Oba, Koji; Naito, Seiji



Chronic inflammation: a poor prognostic factor for endoscopic dacryocystorhinostomy  

Microsoft Academic Search

Endoscopic endonasal dacryocystorhinostomy (En-DCR) success can be affected by many factors. In this study, we aimed to determine\\u000a the effect of chronic inflammation on the surgical outcome of En-DCR. A series of 25 primary En-DCR cases and their lacrimal\\u000a sac specimens were involved in the study. The surgical outcomes were assessed subjectively (satisfied and unsatisfied) and\\u000a objectively (successful and unsuccessful).

Özlem Özer; Görkem Eskiizmir; Halis Ünlü; Ayd?n ??isa?; As?m Aslan


Poor Americans: How the Poor White Live.  

ERIC Educational Resources Information Center

|Contents of this book include the following essays which originally appeared in "Transaction" magazine: (1) "Poor Americans: an introduction," Marc Pilisuk and Phyllis Pilisuk; (2) "How the white poor live," Marc Pilisuk and Phyllis Pilisuk; (3) "The culture of poverty," Oscar Lewis; (4) "Life in Appalachia--the case of Hugh McCaslin," Robert…

Pilisuk, Marc; Pilisuk, Phyllis


Validation of a Dutch Risk Score Predicting Poor Outcome in Adults with Bacterial Meningitis in Vietnam and Malawi  

PubMed Central

We have previously developed and validated a prognostic model to predict the risk for unfavorable outcome in Dutch adults with bacterial meningitis. The aim of the current study was to validate this model in adults with bacterial meningitis from two developing countries, Vietnam and Malawi. Demographic and clinical characteristics of Vietnamese (n?=?426), Malawian patients (n?=?465) differed substantially from those of Dutch patients (n?=?696). The Dutch model underestimated the risk of poor outcome in both Malawi and Vietnam. The discrimination of the original model (c-statistic [c] 0.84; 95% confidence interval 0.81 to 0.86) fell considerably when re-estimated in the Vietnam cohort (c?=?0.70) or in the Malawian cohort (c?=?0.68). Our validation study shows that new prognostic models have to be developed for these countries in a sufficiently large series of unselected patients.

Schut, Ewout S.; Brouwer, Matthijs C.; Scarborough, Matthew; Mai, Nguyen Thi Hoang; Thwaites, Guy E.; Farrar, Jeremy J.; Reitsma, Johannes B.; van de Beek, Diederik



Prognostic Significance of Cytogenetic Clonal Evolution in Patients with Chronic Myelogenous Leukemia on Imatinib Mesylate Therapy  

Microsoft Academic Search

Cytogenetic clonal evolution (CE) is a known poor prognostic factor in Philadel- phia chromosome-positive chronic my- elogenous leukemia (Ph-positive CML). However, its prognostic relevance in the era of imatinib therapy is unknown. We investigated the independent prognostic relevance of CE in 498 patients with Ph- positive CML treated with imatinib for chronic or accelerated phases. One hun- dred twenty-one patients

Jorge E. Cortes; Moshe Talpaz; Francis Giles; Susan O'Brien; Mary Beth Rios; Jianqin Shan; Stefan Faderl; Deborah A. Thomas; William Wierda; Allessandra Ferrajoli; Sima Jeha; Hagop M. Kantarjian



Prognostic factors in adult brainstem gliomas: a multicenter, retrospective analysis of 101 cases  

Microsoft Academic Search

Background Adult brainstem gliomas (BSG) are uncommon and poorly understood with respect to prognostic factors. We retrospectively evaluated\\u000a the clinical, radiographic, histologic, and treatment features from 101 adults with presumed or biopsy proven BSG to determine\\u000a prognostic factors. Patients and Methods We reviewed the records of patients diagnosed from 1987–2005. We used Cox proportional hazard models to determine prognostic\\u000a factors.

Santosh Kesari; Ryung S. Kim; Vassilios Markos; Jan Drappatz; Patrick Y. Wen; Amy A. Pruitt



Prognostic significance of tumor markers in T4a gastric cancer  

PubMed Central

Background The clinical importance of preoperative tumor markers remain elusive in gastric cancer. The aim of this study was to evaluate the prognostic value of AFP, CEA, CA19-9, and CA50 in T4a stage gastric cancer. Methods Two hundred and seventy-three T4a gastric cancer patients who underwent curative D2 gastrectomy between 1996 and 2005 were evaluated. The correlation between tumor markers and clinicopathologic characteristics and prognostic value of preoperative tumor markers were investigated. Results Correlation analysis showed that AFP was associated with Borrmann type (P?=?0.010); CEA with sex (P?=?0.029), tumors site (P?=?0.014), and N stage (P?=?0.001); CA19-9 with age (P?=?0.047), tumor site (P?=?0.011), lymphovascular invasion (P?=?0.004), and N stage (P?=?0.000); CA50 with age (P?=?0.017), tumor site (P?=?0.004), tumor size (P?=?0.014), and N stage (P?=?0.000). Multivariate analysis showed that the positivity of preoperative CEA, CA19-9, and CA50 were major independent poor prognostic factors of patients with T4a stage gastric cancer. Conclusions Preoperative serum tumor marker might be a candidate for the staging system in addition to conventional factors.



Chromosomal aberrations and their prognostic value in a series of 174 untreated patients with Waldenström's macroglobulinemia.  


Waldenström's macroglobulinemia is a disease of mature B cells, the genetic basis of which is poorly understood. Few recurrent chromosomal abnormalities have been reported, and their prognostic value is not known. We conducted a prospective cytogenetic study of Waldenström's macroglobulinemia and examined the prognostic value of chromosomal aberrations in an international randomized trial. The main aberrations were 6q deletions (30%), trisomy 18 (15%), 13q deletions (13%), 17p (TP53) deletions (8%), trisomy 4 (8%), and 11q (ATM) deletions (7%). There was a significant association between trisomy of chromosome 4 and trisomy of chromosome 18. Translocations involving the IGH genes were rare (<5%). Deletion of 6q and 11q, and trisomy 4, were significantly associated with adverse clinical and biological parameters. Patients with TP53 deletion had short progression-free survival and short disease-free survival. Although rare (<5%), trisomy 12 was associated with short progression-free survival. In conclusion, the cytogenetic profile of Waldenström's macroglobulinemia appears to differ from that of other B-cell lymphomas. Chromosomal abnormalities may help with diagnosis and prognostication, in conjunction with other clinical and biological characteristics. PMID:23065509

Nguyen-Khac, Florence; Lambert, Jerome; Chapiro, Elise; Grelier, Aurore; Mould, Sarah; Barin, Carole; Daudignon, Agnes; Gachard, Nathalie; Struski, Stéphanie; Henry, Catherine; Penther, Dominique; Mossafa, Hossein; Andrieux, Joris; Eclache, Virginie; Bilhou-Nabera, Chrystèle; Luquet, Isabelle; Terre, Christine; Baranger, Laurence; Mugneret, Francine; Chiesa, Jean; Mozziconacci, Marie-Joelle; Callet-Bauchu, Evelyne; Veronese, Lauren; Blons, Hélène; Owen, Roger; Lejeune, Julie; Chevret, Sylvie; Merle-Beral, Hélène; Leblondon, Véronique



Prognostic Factors in Myelodysplastic Syndromes  

PubMed Central

ABSTRACT Background: Myelodysplastic syndromes (MDS) are clonal disorders of hematopoietic stem cell and are characterized by ineffective hematopoiesis with normo- or hyper cellular bone marrow and cytopenia(s).The natural evolution of the disease consists of bone marrow failure (leading to infectious and hemorrhagic episodes or anemia related complications) and transformation to acute myeloid leukemia. Because MDSs display remarkable clinical, pathologic, and cytogenetic heterogeneity, with variable evolution and survival ranging from months to years, the predictive factors of prognosis have a key role in optimal therapeutic decisions. The purpose of this paper is to analyze prognostic factors within a group of patients diagnosed with myelodysplastic syndromes. The prognostic factors taken into account are: the number and depth of cytopenias, percentage of bone marrow blasts, cytogenetic abnormalities, intensity of anemia and transfusional dependence. These factors are related to overall survival, leukemia free survival, bone marrow failure complications, leukemic evolution, treatment decisions and the response to treatment. Material and method: The study group comprises of 119 patients diagnosed with de novo MDS, between 2008 and 2011 in the Hematology Department of Coltea Clinical Hospital. In this monitoring period the patients were stratified according to the FAB (French-American-British) morphologic classification. Results: This study revealed that the outcomes of patients with MDS is influenced by the percentage of bone marrow blasts at diagnosis, the number and severity of hematopoietic lineage affected by cytopenia and by the presence of chromosomal abnormalities. Conclusions: The studied prognostic factors have predictive value in terms of survival, leukemic transformation, treatment response and development of bone marrow failure-related characteristic complications.




Sterilizing the Poor  

ERIC Educational Resources Information Center

Suggests that freedom for the middle classes may mean vulnerability for the poor. The enthusiasm for sterilization may be so intense as to deprive the poor of their right not to be sterilized. (Author/AM)

Rothman, Sheila M.



Prognostic Value of Liver Fibrosis Biomarkers  

PubMed Central

Aims and Methods: Several serum biomarkers such as FibroTest, aspartate transaminase-platelet ratio index (APRI), FIB-4, and liver stiffness measurement by FibroScan have been validated as alternatives to biopsy for the diagnosis of fibrosis in patients with chronic liver disease. This paper aims to assess the 5-year prognostic values of these biomarkers. A meta-analysis combined all published prognostic studies. Baseline biopsy and APRI data were used as references. Results: Only 3 biomarkers had several prognostic validations: FibroTest (4 studies; 2,396 patients), APRI (5 studies; 2,422 patients), and FIB-4 (3 studies; 1,184 patients). For the prediction of survival without liver-related death, the areas under the receiver operating characteristic curves (AUROCs) were 0.86 for biopsy (95% confidence interval [CI], 0.77–0.95), 0.88 for FibroTest (95% CI, 0.79–0.98), 0.73 for FIB-4 (95% CI, 0.62–0.85), and 0.66 for APRI (95% CI, 0.57–0.75). APRI had a significantly lower prognostic value versus biopsy, with a mean difference between AUROCs of –0.21 (95% CI, –0.33 to –0.10; P<.001); FIB-4 had a significantly lower prognostic value versus biopsy, with a mean difference between AUROCs of –0.21 (95% CI, –0.20 to –0.02; P=.02). Only FibroTest did not show a significant difference in prognostic value versus biopsy, with a mean difference in AUROCs of +0.02 (95% CI, –0.05 to +0.09; P=.85). Conclusion: FibroTest is a validated biomarker for the prognosis of patients with chronic liver disease.

Ngo, Yen; Perazzo, Hugo; Munteanu, Mona; Lebray, Pascal; Moussalli, Joseph; Thabut, Dominique; Benhamou, Yves; Ratziu, Vlad



Retroperitoneal Sarcoma With Infected Necrosis: An Unfavourable Prognostic Factor  

PubMed Central

Purpose. To report the phenomenon of infected retroperitoneal sarcoma (RPS). Method. Two case reports. Results. Both patients died soon after laparotomy. Discussion. Infected RPS is identified as an entity not clearly documented in the literature. It should probably be added to the list of poor prognostic factors when planning the management of patients with RPS.

Spillane, Andrew J.



The Chronically Poor: Breaking the Cycle.  

ERIC Educational Resources Information Center

This question-and-answer format paper looks at some of the basic issues surrounding the chronically poor and initiatives and services designed to break the poverty cycle. A first section explores some of the myths and realities surrounding the characteristics of the chronically poor population and notes that this population is comprised of…

Morris-Bilotti, Sharon


Significance Analysis of Prognostic Signatures  

PubMed Central

A major goal in translational cancer research is to identify biological signatures driving cancer progression and metastasis. A common technique applied in genomics research is to cluster patients using gene expression data from a candidate prognostic gene set, and if the resulting clusters show statistically significant outcome stratification, to associate the gene set with prognosis, suggesting its biological and clinical importance. Recent work has questioned the validity of this approach by showing in several breast cancer data sets that “random” gene sets tend to cluster patients into prognostically variable subgroups. This work suggests that new rigorous statistical methods are needed to identify biologically informative prognostic gene sets. To address this problem, we developed Significance Analysis of Prognostic Signatures (SAPS) which integrates standard prognostic tests with a new prognostic significance test based on stratifying patients into prognostic subtypes with random gene sets. SAPS ensures that a significant gene set is not only able to stratify patients into prognostically variable groups, but is also enriched for genes showing strong univariate associations with patient prognosis, and performs significantly better than random gene sets. We use SAPS to perform a large meta-analysis (the largest completed to date) of prognostic pathways in breast and ovarian cancer and their molecular subtypes. Our analyses show that only a small subset of the gene sets found statistically significant using standard measures achieve significance by SAPS. We identify new prognostic signatures in breast and ovarian cancer and their corresponding molecular subtypes, and we show that prognostic signatures in ER negative breast cancer are more similar to prognostic signatures in ovarian cancer than to prognostic signatures in ER positive breast cancer. SAPS is a powerful new method for deriving robust prognostic biological signatures from clinically annotated genomic datasets.

Beck, Andrew H.; Knoblauch, Nicholas W.; Hefti, Marco M.; Kaplan, Jennifer; Schnitt, Stuart J.; Culhane, Aedin C.; Schroeder, Markus S.; Risch, Thomas; Quackenbush, John; Haibe-Kains, Benjamin



Rich Donors, Poor Countries  

ERIC Educational Resources Information Center

The shifting ideological winds of foreign aid donors have driven their policy towards governments in poor countries. Donors supported state-led development policies in poor countries from the 1940s to the 1970s; market and private-sector driven reforms during the 1980s and 1990s; and returned their attention to the state with an emphasis on…

Thomas, M. A.



Treatment of poorly differentiated neuroendocrine carcinoma of the pancreas.  


Poorly differentiated neuroendocrine carcinoma is a rare malignancy that remains a challenge to treat. Poorly differentiated neuroendocrine carcinoma occurs at an incidence of 2% annually in United States. The current standard of care is based largely upon retrospective data. There remains a need for large prospective cooperative group trials in the management of poorly differentiated neuroendocrine carcinoma. In this paper, we will review abstract #e15096 (Paclitaxel, carboplatin, and etoposide (TCE) in advanced poorly differentiated neuroendocrine carcinoma) by Loeffler et al. and #e15071 (Poorly differentiated neuroendocrine carcinoma (NEC G3): prognostic factors and potential novel targets) by Heetfeld et al. presented at the 2013 ASCO Annual Meeting highlighting treatment options in first and second lines for poorly differentiated neuroendocrine carcinoma. PMID:23846932

Gupta, Anumeha; Duque, Marvin; Saif, Muhammad Wasif



Clinicopathological, genetic, ultrastructural characterizations and prognostic factors of papillary renal cell carcinoma: new diagnostic and prognostic information.  


Papillary renal cell carcinoma (PRCC) includes two different morphological subtypes. The differences of genetics and ultrastructure of the two subtypes have been rarely reported. Also, new biomarkers related to the diagnosis and prognosis of PRCC have still not been well elucidated. Immunohistochemistry, fluorescence in situ hybridization (FISH) and transmission electron microscopy were used systematically to determine the characteristics of 56 cases of PRCC and to reveal new diagnostic and prognostic information. Type 1 PRCC presented higher expression rates of EMA and CK7, whereas type 2 presented a higher expression rate of CD10. New immunohistochemical markers, including: p504s, PAX-2, PAX-8 and CA-IX showed extensive immunostaining in PRCC. We first revealed a distinct immunostaining pattern of CA-IX, which was located in multiple foci in PRCC. All tumors had at least one chromosomal aberration including loss of Y, gains of 7 or 17. Gain of chromosome 17 was common in type 1; losses of chromosome 18, 11 and 8 appeared in type 2. Ultrastructurally, glycogen granules and secondary lysosomes were seen in type 1, mitochondria and smooth endoplasmic reticulum were scattered in type 2. Tumor subtype, nuclear grade, TNM stage, clear cell renal cell carcinoma (CCRCC) component and sarcomatoid elements, metastasis, CAIX expression, losses of chromosome 18 and 8 were related to poor outcome of PRCC. We conclude that the two subtypes of PRCC originate from different renal cells, and arise from partially common genetic pathways. EMA, CK7, CD10, p504s, PAX-2, PAX-8 and CA-IX are helpful markers in the differential diagnosis of PRCC. CA-IX expression, losses of chromosome 18 and 8 are new prognostic factors of PRCC. PMID:23219441

Yu, Wenjuan; Zhang, Wei; Jiang, Yanxia; Wang, Yuewei; Li, Yujun; Wang, Jigang; Sun, Lingling; Ran, Wenwen; Li, Hong



Prognostic factors in neuroblastoma.  


Between 1951 and 1978 88 patients under 15 years of age were admitted with the diagnosis of neuroblastoma or ganglioneuroblastoma to the Helsinki University Central Hospital for treatment. The relative importance of various prognostic factors for survival was investigated by the use of the Cox regression analysis and by comparison of adjusted survival curves. In regression analysis prior to classification of the patient sample, stage emerged as the overwhelmingly most significant prognostic variable, while histology and age showed a weaker effect and chemotherapy did not display any effect in this setting. Adjusted comparison of survival curves showed significantly improved survival for patients under one year of age in combined stages III and IV, and for stage III patients treated with combination chemotherapy following non-radical surgery. Thus, while stage is the strongest overall prognostic factor, the effect of age is seen especially in the more advanced cases and the beneficial effect of chemotherapy in the cases where radical operation has not been possible. PMID:3740789

Kajanti, M; Holsti, P



Special considerations in prognostic research in cancer involving genetic polymorphisms.  


Analysis of genetic polymorphisms may help identify putative prognostic markers and determine the biological basis of variable prognosis in patients. However, in contrast to other variables commonly used in the prognostic studies, there are special considerations when studying genetic polymorphisms. For example, variable inheritance patterns (recessive, dominant, codominant, and additive genetic models) need to be explored to identify the specific genotypes associated with the outcome. In addition, several characteristics of genetic polymorphisms, such as their minor allele frequency and linkage disequilibrium among multiple polymorphisms, and the population substructure of the cohort investigated need to be accounted for in the analyses. In addition, in cancer research due to the genomic differences between the tumor and non-tumor DNA, differences in the genetic information obtained using these tissues need to be carefully assessed in prognostic studies. In this article, we review these and other considerations specific to genetic polymorphism by focusing on genetic prognostic studies in cancer. PMID:23773794

Savas, Sevtap; Liu, Geoffrey; Xu, Wei



Inflammatory Markers and Poor Outcome after Stroke: A Prospective Cohort Study and Systematic Review of Interleukin6  

Microsoft Academic Search

In a prospective cohort study of patient outcomes following stroke, William Whiteley and colleagues find that markers of inflammatory response are associated with poor outcomes. However, addition of these markers to existing prognostic models does not improve outcome prediction.

William Whiteley; Caroline Jackson; Steff Lewis; Gordon Lowe; Ann Rumley; Peter Sandercock; Joanna Wardlaw; Martin Dennis; Cathie Sudlow



Prognostic implication of late gadolinium enhancement on cardiac MRI in light chain (AL) amyloidosis on long term follow up  

Microsoft Academic Search

BACKGROUND: Light chain amyloidosis (AL) is a rare plasma cell dyscrasia associated with poor survival especially in the setting of heart failure. Late gadolinium enhancement (LGE) on cardiac MRI was recently found to correlate with myocardial amyloid deposition but the prognostic role is not established. The aim is to determine the prognostic significance of LGE in AL by comparing long

Raymond Q Migrino; Richard Christenson; Aniko Szabo; Megan Bright; Seth Truran; Parameswaran Hari



Low SIRT3 expression correlates with poor differentiation and unfavorable prognosis in primary hepatocellular carcinoma.  


SIRT3, a mitochondrial sirtuin belonging to nicotinamide adenine nucleotide (NAD) dependent deacetylases, is implicated in metabolism, longevity and carcinogenesis. SIRT3 expression and its significance in hepatocellular carcinoma (HCC) remain largely unclear. In this study, we demonstrated that SIRT3 expression in HCC tissue was much lower than that in paracarcinoma tissue, at both mRNA and protein levels. The cutoff value for low SIRT3 expression in HCC was defined according to receiver operating characteristic curve (ROC) analysis. As disclosed by immunohistochemistry (IHC) results, low SIRT3 expression was present in 67.3% (167/248) of HCC cases. Furthermore, low expression of SIRT3 was significantly correlated to differentiation (P?=?0.013), clinical stage (P?=?0.005), serum AFP level (P<0.01), tumor multiplicity (P?=?0.026) and relapse (P?=?0.028). Moreover, Kaplan-Meier analysis indicated that low SIRT3 expression associated with unfavorable overall survival (P<0.01) and recurrence-free survival (P?=?0.004). The prognostic impact of SIRT3 was further confirmed by stratified survival analysis. Importantly, multivariate analysis revealed that low SIRT3 expression was an independent poor prognostic marker for overall survival (Hazard Ratio (HR) 0.555, 95% confidence interval (95% CI) 0.344-0.897, P?=?0.016). Collectively, we conclude that SIRT3 is decreased in HCC and is a novel unfavorable marker for prognosis of patients with this fatal disease. PMID:23272146

Zhang, Chris Zhiyi; Liu, Lili; Cai, Muyan; Pan, Yinghua; Fu, Jia; Cao, Yun; Yun, Jingping



Benign multiple sclerosis? Clinical course, long term follow up, and assessment of prognostic factors  

Microsoft Academic Search

OBJECTIVETo establish the characteristics of patients following a benign course of multiple sclerosis and evaluate the importance of potential prognostic factors. Also, an assessment of the value of the Kurtzke EDSS as a prognostic indicator has been undertaken in patients previously determined to have benign multiple sclerosis, after 10 years of follow up.METHODSA prevalence study in the Coleraine, Ballymena, Ballymoney,

S A Hawkins; G V McDonnell



A New Palliative Prognostic Score  

Microsoft Academic Search

In recent years, extensive research has been performed to identify prognostic factors that predict survival in terminally ill cancer patients. This study describes the construction of a simple prognostic score based on factors identified in a prospective multicenter study of 519 patients with a median survival of 32 days. An exponential multiple regression model was adopted to evaluate the joint

Marco Pirovano; Marco Maltoni; Oriana Nanni; Mauro Marinari; Monica Indelli; Giovanni Zaninetta; Vincenzo Petrella; Sandro Barni; Ernesto Zecca; Emanuela Scarpi; Roberto Labianca; Dino Amadori; Gino Luporini



Prognostic indicators in venous ulcers  

Microsoft Academic Search

Background: Venous ulcers can be difficult to heal, and prognostic factors for healing have not been fully elucidated. Objective: The objective of this study was to analyze the results of a large multicenter venous ulcer trial to retrospectively establish prognostic factors for venous ulcer healing. Methods: This study examined data from a previously published prospective randomized placebo-controlled trial of an

Tania J. Phillips; Fidelis Machado; Richard Trout; John Porter; Jeffrey Olin; Vincent Falanga



Prognostic Scale for Chronic Schizophrenia  

Microsoft Academic Search

Although prognostic scales are available for schizophrenia, these focus on acute or subacute populations where premorbid functioning and established chronicity are the best predictors of outcome. Their usefulness in chronic schizophrenia is limited. The authors describe a simple and reliable 5-item, 12-point prognostic scale for chronic schizophrenia independent of chronicity. It measures prognosis as the product of a dynamic interplay

Wayne S. Fenton; Thomas H. McGlashan



High expression of FER tyrosine kinase predicts poor prognosis in clear cell renal cell carcinoma  

PubMed Central

FER tyrosine kinase (FER) has been demonstrated to play a critical role in tumorigenesis and metastasis; however, its potential value as a novel prognostic marker for clear cell renal cell carcinoma (ccRCC) remains unclear. In 48 paired samples of ccRCCs and normal adjacent tissues (ADTs), real-time PCR was used to evaluate the expression of FER mRNA. The expression of FER protein was assessed in 87 ADTs and 206 samples of ccRCC using immunohistochemical methods. Statistical analysis was used to examine the correlations between the expression levels of FER and the clinical characteristics of ccRCC patients. A significant difference was identified between ccRCC tissues and ADTs in the mRNA levels of FER. Immunohistochemistry analyses revealed higher expression of FER protein in 87 ccRCC samples compared to the paired ADTs. In addition, FER protein expression in 206 ccRCC samples was significantly correlated with tumor size, T stage, N classification, metastasis, recurrence and Fuhrman grade, while associations with age and gender were not identifed. The Kaplan-Meier survival analysis showed that patients with high FER levels had a poorer survival outcome compared with those with lower levels. The log-rank test demonstrated that the cumulative survival rates were significantly different between the two groups. The Cox regression analysis indicated that FER expression, N stage and distant metastasis were independent prognostic factors for overall survival of ccRCC patients. Our results indicate that overexpression of FER in tumor tissues predicts a poor prognosis of patients with ccRCC, and FER may serve as a novel prognostic marker for ccRCC.




High expression of FER tyrosine kinase predicts poor prognosis in clear cell renal cell carcinoma.  


FER tyrosine kinase (FER) has been demonstrated to play a critical role in tumorigenesis and metastasis; however, its potential value as a novel prognostic marker for clear cell renal cell carcinoma (ccRCC) remains unclear. In 48 paired samples of ccRCCs and normal adjacent tissues (ADTs), real-time PCR was used to evaluate the expression of FER mRNA. The expression of FER protein was assessed in 87 ADTs and 206 samples of ccRCC using immunohistochemical methods. Statistical analysis was used to examine the correlations between the expression levels of FER and the clinical characteristics of ccRCC patients. A significant difference was identified between ccRCC tissues and ADTs in the mRNA levels of FER. Immunohistochemistry analyses revealed higher expression of FER protein in 87 ccRCC samples compared to the paired ADTs. In addition, FER protein expression in 206 ccRCC samples was significantly correlated with tumor size, T stage, N classification, metastasis, recurrence and Fuhrman grade, while associations with age and gender were not identifed. The Kaplan-Meier survival analysis showed that patients with high FER levels had a poorer survival outcome compared with those with lower levels. The log-rank test demonstrated that the cumulative survival rates were significantly different between the two groups. The Cox regression analysis indicated that FER expression, N stage and distant metastasis were independent prognostic factors for overall survival of ccRCC patients. Our results indicate that overexpression of FER in tumor tissues predicts a poor prognosis of patients with ccRCC, and FER may serve as a novel prognostic marker for ccRCC. PMID:23420638

Wei, Can; Wu, Song; Li, Xianxin; Wang, Yadong; Ren, Rui; Lai, Yongqing; Ye, Jiongxian



The Poor Pay More.  

ERIC Educational Resources Information Center

|Describes a sociology experiential learning assignment where students learned why people living in poverty can sometimes pay more for products than people with better incomes. Focuses specifically on the rent to own concept. States students achieved the goal of learning how life constraints of poverty can hinder the poor from overcoming their…

Folse, Kimberly A.



Urban poor children.  


One-half of the world's population lives in cities and towns; this is expected to increase to 70% by 2050. One in three urban dwellers lives in slums. As the urban population grows, so does the number of urban poor. Out of a billion children living in urban areas, approximately 300 million are suffering from exclusion or are at risk of exclusion. Urban poor children are devoid of basic rights of survival, development and protection and are marginalised in challenging conditions in overcrowded settlements. Rapid urbanisation and the consequent increase in urban population is one of the biggest challenges that developing countries, including India are facing. Thirty per cent (that is, 367.5 million) of India's population of 1.23 billion live in urban areas. Moreover, this figure is increasing rapidly and is expected to reach 432 million (40%) by 2021. Rapid urbanisation has unfortunately outpaced development, and a large proportion (43 million) live in substandard conditions in slums. Now is the time to pay attention to the basic rights of the urban poor, especially the urban poor children, the most vulnerable group at the launching of 12(th) Five-Year Plan & National Urban Health Mission (NUHM) in India. PMID:23837083

Ambey, Ravi; Gaur, Ajay; Gupta, Richa; Patel, Gs



Preoperative radiotherapy for rectal adenocarcinoma: Which are strong prognostic factors?  

SciTech Connect

Purpose: This retrospective 12-year study evaluated the prognostic value of initial and postoperative staging of rectal tumors. Methods and Materials: Between 1985 and 1996, 297 patients were treated with preoperative radiotherapy (39 Gy in 13 fractions) and surgery for Stage T2-T4N0-N1M0 rectal adenocarcinoma. Pretreatment staging included a clinical examination and endorectal ultrasonography (EUS) since 1988. Clinical staging was performed by digital rectal examination and rigid proctoscopy. EUS was performed in 236 patients. Postoperative staging was performed by examination of the pathologic specimen. Results: The median follow-up was 49 months. The overall 5-year survival rate was 67%, with a local failure rate of 9%. The rate of sphincter preservation was 65%. The clinical examination findings were strong prognostic factor for both cT stage (p < 0.001) and cN stage (p < 0.006) but had poor specificity for cN stage (only 25 lymph nodes detected). In both univariate and multivariate analyses, EUS had a statistically significant prognostic value for uT (p < 0.014) but not for uN (p < 0.47) stage. In contrast, pT and pN stages were strong prognostic factors (p < 0.001 and p < 0.001, respectively). Conclusion: Pretreatment staging, including clinical examination and EUS, seemed accurate enough to present a high prognostic value for the T stage. EUS was insufficient to stage lymph node involvement. Owing to its lack of specificity, uN stage was not a reliable prognostic factor. An improvement in N staging is necessary and essential. Despite downstaging, postoperative staging remained a very strong prognostic factor for both T and N stages.

Chapet, Olivier [Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Benite (France)]. E-mail:; Romestaing, Pascale [Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Benite (France); Mornex, Francoise [Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Benite (France); Souquet, Jean-Christophe [Department of Gastroenterology, Croix Rousse Hospital, Lyon (France); Favrel, Veronique [Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Benite (France); Ardiet, Jean-Michel [Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Benite (France); D'Hombres, Anne [Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Benite (France); Gerard, Jean-Pierre [Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Benite (France)



Expression of the proapoptotic protein Bid is an adverse prognostic factor for radiotherapy outcome in carcinoma of the cervix  

PubMed Central

The Bcl-2 family of apoptotic regulators is thought to play an essential role in cancer development and influence the sensitivity of tumour cells to radiotherapy. Bid is an abundantly expressed Bcl-2 family protein playing a central role in various pathways of apoptosis by integrating and converging signals at the mitochondria. The relevance of apoptotic modulation by Bcl-2 and related proteins in tumour development and radiation response for human tumours remains undefined. Therefore, a study was made regarding the expression of Bid in patients with locally advanced cervix carcinoma who received radiotherapy. Bid expression was assessed using immunohistochemistry in pretreatment archival biopsies from 98 patients. The data were correlated with clinicopathologic characteristics and treatment outcome. Pretreatment tumour radiosensitivity data were available for 60 patients. Strong Bid expression was associated with a patient age less than the median of 52 years (P=0.034) and poor metastasis-free survival. In multivariate analysis, after allowing for stage, Bid expression was a significant prognostic factor for both disease-specific and metastasis-free survival (P=0.026). It is concluded that strong tumour Bid expression is associated with poor outcome following radiotherapy regardless of intrinsic tumour cell radiosensitivity, and is adverse prognostic for disease-specific and metastasis-free survival in younger patients.

Green, M M L; Hutchison, G J; Valentine, H R; Fitzmaurice, R J; Davidson, S E; Hunter, R D; Dive, C; West, C M L; Stratford, I J



p53 immunohistochemistry as an independent prognostic factor for superficial transitional cell carcinoma of the bladder.  

PubMed Central

Although patients with superficial bladder cancer (Ta, T1) have a generally good prognosis, those patients who develop muscle-invasive tumours or metastatic disease at recurrence do poorly clinically. In the current study 69 patients undergoing complete transurethral resection for superficial transitional cell cancer of the bladder were investigated for different clinical and biological characteristics as possible prognostic factors: age, sex, performance of instillation therapy and immunohistochemical determination of mutational inactivation of p53 tumour-suppressor gene (monoclonal antibody PAb 1801) as well as immunohistochemical determination of the proliferation rate by staining for PCNA (proliferating cell nuclear antigen) (monoclonal antibody PC 10). After a median follow-up of 45.8 months, 12 of 14 patients (85.7%) with more than 20% of cells positive for p53 had disease progression with muscle-invasive growth compared with only one of 55 patients (1.8%) negative for p53 (P < 0.01, chi 2 test). During univariate analysis histological grade (G1 vs G2) (P = 0.0373), positivity for PCNA (> 60% of cells) (P = 0.0033) and positivity for p53 (P < 0.001) were significant prognostic factors for disease progression (log-rank test), while during multivariate analysis only positivity for p53 was a significant predictor for relapse of bladder cancer (P = 0.0029) (multivariate Cox regression analysis). The immunohistochemical detection of mutations of the p53 gene has been demonstrated to be a reliable, easily performed and thereby widely available technique for the investigation of fresh-frozen or paraffin-embedded tumour specimens. The results demonstrate the important role of the p53 tumour-suppressor gene protein in the development and for the progression of bladder cancer. If the high prognostic value of p53 mutations in superficial bladder cancer is confirmed in larger prospective trials, more aggressive therapeutic strategies could be discussed for patients with p53 mutations in their tumour specimens.

Serth, J.; Kuczyk, M. A.; Bokemeyer, C.; Hervatin, C.; Nafe, R.; Tan, H. K.; Jonas, U.



Colorectal cancer: prognostic values.  


After lung cancer colorectal cancer (Cc) is ranked the second, as a cause of cancer-related death. The purpose of this study was to analyze the Cc cases in our material with respect to all prognostic values including histological type and grade, vascular invasion, perineural invasion, and tumor border features. There were investigated 149 cases of resection specimen with colorectal cancer, which were fixed in buffered neutral formalin and embedded in paraffin. Tissue sections (4(mum thick) were cut and stained with H&E. Adenocarcinoma was the most frequent histological type found in 85,90% of cases, in 60,94% of males and 39,06% of females; squamous cell carcinoma in 7,38%, in 63,63% of males and 36,36% of females; mucinous carcinoma in 4,68%, in 57,15% of males and 42,85% of females; while adenosquamous carcinoma, undifferentiated carcinoma and carcinoma in situ in 0,71% of cases each. Dukes' classification was used in order to define the depth of invasion. Dukes B was found in 68,45% of cases, whereas in 31,54% of cases Dukes C was found. As far as histological grading is concerned, Cc was mostly with moderate differentiation (75,16%) with neither vascular nor perineural invasion. Resection margins were in all cases free of tumor. Our data indicate that the pathologic features of the resection specimen constitute the most powerful predictors of postoperative outcome in Cc. Dukes' stage and degree of differentiation provide independent prognostic information in Cc. However, differentiation should be assessed by the worst pattern. PMID:19284390

Manxhuka-Kerliu, Suzana; Telaku, Skender; Ahmetaj, Halil; Baruti, Arijeta; Loxha, Sadushe; Kerliu, Agron



A Novel Statistical Prognostic Score Model That Includes Serum CXCL5 Levels and Clinical Classification Predicts Risk of Disease Progression and Survival of Nasopharyngeal Carcinoma Patients  

PubMed Central

Background Aberrant expression of C-X-C motif chemokine 5 (CXCL5) contributes to the progression of various cancers. This study analyzed the clinical significance of serum CXCL5 (sCXCL5) levels of nasopharyngeal carcinoma (NPC) patients, with the goal of building a novel prognostic score model. Experimental Design Serum samples were collected prior to treatment from 290 NPC patients for the detection of sCXCL5 with ELISA. Half of the patients (n?=?145) were randomly assigned to the training set to generate the sCXCL5 cutoff point using receiver operator characteristic (ROC) analysis, while the other half (n?=?145) were assigned to the testing set for validation. Associations between sCXCL5 levels and clinical characteristics were analyzed. A prognostic score model was built using independent predictors derived from multivariate analysis. A concordance index (C-Index) was used to evaluate prognostic ability. Results The sCXCL5 cutoff point was 0.805 ng/ml. Sex, age, histology, T classification, clinical classification and local recurrence were not associated with sCXCL5 levels. However, sCXCL5 levels were positively associated with N classification, distant metastasis and disease progression (P<0.05). A high sCXCL5 level predicted poor 6-year overall survival (OS), poor 6-year distant metastasis-free survival (DMFS), and poor 6-year progression-free survival (PFS). A prognostic score model was subsequently constructed based on sCXCL5 levels and clinical classification (C-C model), which are independent predictors of OS, DMFS, and PFS, as confirmed by the multivariate analysis. Furthermore, this novel model successfully divided the patients into four risk subgroups in the training set, the testing set and the entire set of patients. The C-Indices were 0.751 and 0.762 for the training set and the testing set, respectively. Conclusions sCXCL5 level was determined to be an independent prognostic factor for NPC patients. The novel statistical C-C model, which includes sCXCL5 levels and clinical classification, could be helpful in predicting the prognosis of NPC patients.

Lu, Xing; Sun, Rui; Wang, Lin; Zheng, Lisheng; Ye, Yanfang; Bao, Yingna; Xiang, Yanqun; Guo, Xiang



Multiple myeloma-associated amyloidosis is an independent high-risk prognostic factor  

Microsoft Academic Search

Several prognostic factors have been recognized in patients with multiple myeloma (MM). Among the most important are: the\\u000a serum levels of ?2-microglobulin, albumin, and LDH; the labeling index; and an abnormal karyotype. Patients with amyloidosis\\u000a (AL) have poor prognosis; however, little is known concerning the prognostic significance of AL associated to MM. In 201 consecutive\\u000a patients with de novo MM,

J. Vela-Ojeda; M. A. García-Ruiz Esparza; Y. Padilla-González; E. Sánchez-Cortes; J. García-Chávez; L. Montiel-Cervantes; E. Reyes-Maldonado; A. Majluf-Cruz; H. Mayani



Prognostic and health management for aircraft electrical power supply system  

Microsoft Academic Search

According to the electrical power supply system analysis, a system of prognostic and health management (PHM) for the electrical power supply system is presented. The PHM system can accomplish the condition assessment of the key characteristics and device in the electrical power supply system without additional test equipment. The condition of rotating rectifier, contact resistance and so on can be

Haiyang Pan; Ensheng Dong; Yilin Jiang; Ping Zhang



Prognostic value of nuclear DNA content in papillary thyroid carcinoma  

Microsoft Academic Search

The prognostic value of nuclear DNA content in papillary thyroid carcinoma was studied retrospectively in 90 patients. Eighty survived for at least 10 years, and 10 died, of papillary thyroid carcinoma, between 6 months and 12 years after diagnosis. Clinical data as well as morphological tumor characteristics were examined. DNA measurements in morphologically identified single tumor cells were performed either

Kenneth Cohn; Martin Bfickdahl; Gun Forsslund; Gert Auer; Göran Lundell; Torsten Löwhagen; Eva Tallroth; Jan-Silvester Willems; Anders Zetterberg; Per-Ola Granberg



Anaplastic Oligodendrogliomas: Prognostic Factors for Tumor Recurrence and Survival  

Microsoft Academic Search

Objectives: Anaplastic oligodendrogliomas (AO) are uncommon primary brain tumors whose natural history, prognosis, and optimal management are not yet fully understood. However, they are associated with a better prognosis and response to multimodality therapy based on specific molecular changes. In this multicenter retrospective study, we analyzed the clinical characteristics of patients with AO to identify prognostic factors that influence time

Vinay K. Puduvalli; Masood Hashmi; Leslie D. McAllister; Victor A. Levin; Kenneth R. Hess; Michael Prados; Kurt A. Jaeckle; W. K. Alfred Yung; Saundra S. Buys; Janet M. Bruner; Jeannette J. Townsend; Richard Davis; Raymond Sawaya; Athanassios P. Kyritsis



Prognostic factors in prostate cancer  

PubMed Central

Prognostic factors in organ confined prostate cancer will reflect survival after surgical radical prostatectomy. Gleason score, tumour volume, surgical margins and Ki-67 index have the most significant prognosticators. Also the origins from the transitional zone, p53 status in cancer tissue, stage, and aneuploidy have shown prognostic significance. Progression-associated features include Gleason score, stage, and capsular invasion, but PSA is also highly significant. Progression can also be predicted with biological markers (E-cadherin, microvessel density, and aneuploidy) with high level of significance. Other prognostic features of clinical or PSA-associated progression include age, IGF-1, p27, and Ki-67. In patients who were treated with radiotherapy the survival was potentially predictable with age, race and p53, but available research on other markers is limited. The most significant published survival-associated prognosticators of prostate cancer with extension outside prostate are microvessel density and total blood PSA. However, survival can potentially be predicted by other markers like androgen receptor, and Ki-67-positive cell fraction. In advanced prostate cancer nuclear morphometry and Gleason score are the most highly significant progression-associated prognosticators. In conclusion, Gleason score, capsular invasion, blood PSA, stage, and aneuploidy are the best markers of progression in organ confined disease. Other biological markers are less important. In advanced disease Gleason score and nuclear morphometry can be used as predictors of progression. Compound prognostic factors based on combinations of single prognosticators, or on gene expression profiles (tested by DNA arrays) are promising, but clinically relevant data is still lacking.

Buhmeida, A; Pyrhonen, S; Laato, M; Collan, Y



Prognostic factors in prostate cancer.  


Prognostic factors in organ confined prostate cancer will reflect survival after surgical radical prostatectomy. Gleason score, tumour volume, surgical margins and Ki-67 index have the most significant prognosticators. Also the origins from the transitional zone, p53 status in cancer tissue, stage, and aneuploidy have shown prognostic significance. Progression-associated features include Gleason score, stage, and capsular invasion, but PSA is also highly significant. Progression can also be predicted with biological markers (E-cadherin, microvessel density, and aneuploidy) with high level of significance. Other prognostic features of clinical or PSA-associated progression include age, IGF-1, p27, and Ki-67. In patients who were treated with radiotherapy the survival was potentially predictable with age, race and p53, but available research on other markers is limited. The most significant published survival-associated prognosticators of prostate cancer with extension outside prostate are microvessel density and total blood PSA. However, survival can potentially be predicted by other markers like androgen receptor, and Ki-67-positive cell fraction. In advanced prostate cancer nuclear morphometry and Gleason score are the most highly significant progression-associated prognosticators. In conclusion, Gleason score, capsular invasion, blood PSA, stage, and aneuploidy are the best markers of progression in organ confined disease. Other biological markers are less important. In advanced disease Gleason score and nuclear morphometry can be used as predictors of progression. Compound prognostic factors based on combinations of single prognosticators, or on gene expression profiles (tested by DNA arrays) are promising, but clinically relevant data is still lacking. PMID:16759347

Buhmeida, A; Pyrhönen, S; Laato, M; Collan, Y



Has admission blood pressure any prognostic value in patients with subarachnoid hemorrhage: an emergency department experience.  


Hypertension is a well-known risk factor for the development and rupture of cerebral aneurysms. The authors conducted a study to investigate the prognostic value of admission blood pressure (BP) on prognosis in patients with subarachnoid hemorrhage (SAH). Two hundred patients with SAH were divided into two groups according to Hunt Hess score (good prognosis: 1 to 3, and poor prognosis: 4 and 5) and according to death in hospital (surveyed and died). The prognostic factors of SAH and BP changes according to Hunt Hess scores in the acute stages of the event were evaluated. Admission mean arterial BP values of the patients who died in hospital were significantly lower than in the patients who were surveyed (P=.026). The admission mean arterial BP values were found to be lower in the poor prognostic patients (Hunt Hess score of 4 and 5) (P<.001). Decreased admission BP values were found to be associated with poor prognosis and mortality. PMID:24088282

Duran, Latif; Balci, Kemal; Kati, Celal; Akdemir, H?z?r Ufuk; Kocabicak, Ersoy; Do?ruel, Canan



Prognostic biomarkers in osteoarthritis  

PubMed Central

Purpose of review Identification of patients at risk for incident disease or disease progression in osteoarthritis remains challenging, as radiography is an insensitive reflection of molecular changes that presage cartilage and bone abnormalities. Thus there is a widely appreciated need for biochemical and imaging biomarkers. We describe recent developments with such biomarkers to identify osteoarthritis patients who are at risk for disease progression. Recent findings The biochemical markers currently under evaluation include anabolic, catabolic, and inflammatory molecules representing diverse biological pathways. A few promising cartilage and bone degradation and synthesis biomarkers are in various stages of development, awaiting further validation in larger populations. A number of studies have shown elevated expression levels of inflammatory biomarkers, both locally (synovial fluid) and systemically (serum and plasma). These chemical biomarkers are under evaluation in combination with imaging biomarkers to predict early onset and the burden of disease. Summary Prognostic biomarkers may be used in clinical knee osteoarthritis to identify subgroups in whom the disease progresses at different rates. This could facilitate our understanding of the pathogenesis and allow us to differentiate phenotypes within a heterogeneous knee osteoarthritis population. Ultimately, such findings may help facilitate the development of disease-modifying osteoarthritis drugs (DMOADs).

Attur, Mukundan; Krasnokutsky-Samuels, Svetlana; Samuels, Jonathan; Abramson, Steven B.



Temporal measures of poor and proficient handwriters  

Microsoft Academic Search

The objective of this study was to use quantitative outcome measures of children's handwriting to examine differences in the temporal characteristics of proficient and poor handwriters. This was accomplished by using an x-y digitizer to sample the handwriting of 100 third grade children as they performed a series of functional tasks of varying length and complexity. A major finding was



Proliferating macrophages associated with high grade, hormone receptor negative breast cancer and poor clinical outcome.  


Macrophages, a key cell in the inflammatory cascade, have been associated with poor prognosis in cancers, including breast cancer. In this study, we investigated the relationship of a subset of macrophages-proliferating macrophages (promacs)-with clinico-pathologic characteristics of breast cancer, including tumor size, grade, stage, lymph node metastases, hormone receptor status, subtype, as well as early recurrence, and survival. This study included a discovery and validation set that was conducted at two institutions and laboratories (University of California, San Francisco and University of Chicago) using two independent cohorts of patients with breast cancer. Formalin-fixed, paraffin-embedded sections and/or tissue microarrays were double-stained with anti-CD68 (a macrophage marker) and anti-PCNA (a proliferation marker) antibodies. The presence of intratumoral promacs was significantly correlated with high grade, hormone receptor negative tumors, and a basal-like subtype. In contrast, there was no correlation between promacs and tumor size, stage, or the number of the involved lymph nodes. These findings were consistent between the two study cohorts. Finally, promac numbers were a significant predictor of recurrence and survival. In the pooled analysis, elevated promac levels were associated with a 77% increased risk of dying (P = 0.015). The presence of promacs in human breast cancer may serve as a prognostic indicator for poor outcomes and early recurrence and serve as a potential cellular target for novel therapeutic interventions. PMID:20842526

Campbell, Michael J; Tonlaar, Nathan Y; Garwood, Elisabeth R; Huo, Dezheng; Moore, Dan H; Khramtsov, Andrey I; Au, Afred; Baehner, Frederick; Chen, Yinghua; Malaka, David O; Lin, Amy; Adeyanju, Oyinlolu O; Li, Shihong; Gong, Can; McGrath, Michael; Olopade, Olufunmilayo I; Esserman, Laura J



Elevated expression of SHIP2 correlates with poor prognosis in non-small cell lung cancer  

PubMed Central

SH2-containing inositol 5’-phosphatase 2 (SHIP2) is a vital regulator of phosphoinositide pools in metabolic pathways and is considered to downregulate phosphatidylinositol 3’-kinase signaling, which underlies the development of several kinds of human cancers. However, SHIP2 expression in non-small cell lung cancer (NSCLC) and its relationship with the clinical characteristics of NSCLC remain poorly understood. In this study, one-step quantitative reverse transcription-polymerase chain reaction and immunohistochemistry analysis with tissue microarray was used to evaluate SHIP2 expression in NSCLC and to investigate the relationship of this expression to NSCLC prognosis. Results showed that the expression of SHIP2 messenger RNA and protein was significantly higher in NSCLC than in corresponding non-cancerous tissues (both p < 0.05). SHIP2 protein expression in NSCLC was related to lymph node metastasis (p = 0.042), TNM stage (p = 0.036), and 5-year survival rate (p = 0.046). The Kaplan-Meier method and log-rank test suggested that high SHIP2 expression, tobacco consumption, and advanced tumor stage were significantly associated with low survival of NSCLC patients. The results of this research suggested that SHIP2 expression was correlated with malignant phenotypes of NSCLC and may thus serve as a poor prognostic factor and valuable oncogene for NSCLC.

Fu, Maoying; Fan, Weifei; Pu, Xiaolin; Ni, Huihui; Zhang, Wei; Chang, Feng; Gong, Li; Xiong, Lin; Wang, Jun; Gu, Xuefeng



Homogeneous Datasets of Triple Negative Breast Cancers Enable the Identification of Novel Prognostic and Predictive Signatures  

PubMed Central

Background Current prognostic gene signatures for breast cancer mainly reflect proliferation status and have limited value in triple-negative (TNBC) cancers. The identification of prognostic signatures from TNBC cohorts was limited in the past due to small sample sizes. Methodology/Principal Findings We assembled all currently publically available TNBC gene expression datasets generated on Affymetrix gene chips. Inter-laboratory variation was minimized by filtering methods for both samples and genes. Supervised analysis was performed to identify prognostic signatures from 394 cases which were subsequently tested on an independent validation cohort (n?=?261 cases). Conclusions/Significance Using two distinct false discovery rate thresholds, 25% and <3.5%, a larger (n?=?264 probesets) and a smaller (n?=?26 probesets) prognostic gene sets were identified and used as prognostic predictors. Most of these genes were positively associated with poor prognosis and correlated to metagenes for inflammation and angiogenesis. No correlation to other previously published prognostic signatures (recurrence score, genomic grade index, 70-gene signature, wound response signature, 7-gene immune response module, stroma derived prognostic predictor, and a medullary like signature) was observed. In multivariate analyses in the validation cohort the two signatures showed hazard ratios of 4.03 (95% confidence interval [CI] 1.71–9.48; P?=?0.001) and 4.08 (95% CI 1.79–9.28; P?=?0.001), respectively. The 10-year event-free survival was 70% for the good risk and 20% for the high risk group. The 26-gene signatures had modest predictive value (AUC?=?0.588) to predict response to neoadjuvant chemotherapy, however, the combination of a B-cell metagene with the prognostic signatures increased its response predictive value. We identified a 264-gene prognostic signature for TNBC which is unrelated to previously known prognostic signatures.

Karn, Thomas; Pusztai, Lajos; Holtrich, Uwe; Iwamoto, Takayuki; Shiang, Christine Y.; Schmidt, Marcus; Muller, Volkmar; Solbach, Christine; Gaetje, Regine; Hanker, Lars; Ahr, Andre; Liedtke, Cornelia; Ruckhaberle, Eugen; Kaufmann, Manfred; Rody, Achim



Prognostic Factors After Extraneural Metastasis of Medulloblastoma  

SciTech Connect

Purpose: To review the existing literature regarding the characteristics, prognostic factors, treatment, and survival of patients with medulloblastoma, who develop extraneural metastasis (ENM). Methods and Materials: A PubMed search of English language articles from 1961 to 2007 was performed, yielding 47 articles reporting on 119 patients. Factors analyzed included age, time interval to development of ENM, ENM location, central nervous system (CNS) involvement, treatment, and outcome. Results: Sites of ENM included bone in 84% of patients, bone marrow in 27% of patients, lymph nodes in 15% of patients, lung in 6% of patients, and liver in 6% of patients. Median survival was 8 months after diagnosis of ENM. The 1-, 2-, and 5-year overall survival (OS) rates after diagnosis of ENM were 41.9%, 31.0%, and 26.0%, respectively. The 1-, 2-, and 5-year progression-free survival (PFS) rates after diagnosis of ENM were 34.5%, 23.2%, and 13.4%, respectively. For patients without CNS involvement at the time of ENM diagnosis, the 1-, 2-, and 5-year OS rates for those treated with and without radiotherapy (RT) were 82.4%, 64.8%, and 64.8% vs. 51.0%, 36.6%, and 30.5%, respectively (p = 0.03, log-rank test). RT did not significantly improve OS or PFS rates for those with CNS involvement. Concurrent CNS involvement, ENM in the lung or liver, a time interval of <18 months to development of ENM, and a patient age of <16 years at ENM diagnosis were found to be negative prognostic factors for both OS and PFS. Conclusions: Several prognostic factors were identified for patients with ENM from medulloblastoma. Patients without concurrent CNS involvement, who received RT after ENM diagnosis had an OS and PFS benefit compared to those who did not receive RT.

Mazloom, Ali [Department of Radiology, Section of Radiation Oncology, Methodist Hospital, Houston, Texas (United States); Zangeneh, Azy H. [Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, Texas (United States); Paulino, Arnold C., E-mail: apaulino@tmhs.or [Department of Radiology, Section of Radiation Oncology, Methodist Hospital, Houston, Texas (United States); Department of Radiation Oncology, Methodist Hospital, Houston, Texas (United States)



Prognostic gene expression signature associated with two molecularly distinct subtypes of colorectal cancer  

PubMed Central

Aims Despite continual efforts to develop prognostic and predictive models of colorectal cancer by using clinicopathological and genetic parameters, a clinical test that can discriminate between patients with good or poor outcome after treatment has not been established. Thus, the authors aim to uncover subtypes of colorectal cancer that have distinct biological characteristics associated with prognosis and identify potential biomarkers that best reflect the biological and clinical characteristics of subtypes. Methods Unsupervised hierarchical clustering analysis was applied to gene expression data from 177 patients with colorectal cancer to determine a prognostic gene expression signature. Validation of the signature was sought in two independent patient groups. The association between the signature and prognosis of patients was assessed by Kaplan–Meier plots, log-rank tests and the Cox model. Results The authors identified a gene signature that was associated with overall survival and disease-free survival in 177 patients and validated in two independent cohorts of 213 patients. In multivariate analysis, the signature was an independent risk factor (HR 3.08; 95% CI 1.33 to 7.14; p=0.008 for overall survival). Subset analysis of patients with AJCC (American Joint Committee on Cancer) stage III cancer revealed that the signature can also identify the patients who have better outcome with adjuvant chemotherapy (CTX). Adjuvant chemotherapy significantly affected disease-free survival in patients in subtype B (3-year rate, 71.2% (CTX) vs 41.9% (no CTX); p=0.004). However, such benefit of adjuvant chemotherapy was not significant for patients in subtype A. Conclusion The gene signature is an independent predictor of response to chemotherapy and clinical outcome in patients with colorectal cancer.

Oh, Sang Cheul; Park, Yun-Yong; Park, Eun Sung; Lim, Jae Yun; Kim, Soo Mi; Kim, Sang-Bae; Kim, Jongseung; Kim, Sang Cheol; Chu, In-Sun; Smith, J Joshua; Beauchamp, R Daniel; Yeatman, Timothy J; Kopetz, Scott; Lee, Ju-Seog



[Prognostic factors in breast cancer].  


Prognostic factors are clinical and pathological features that give information in estimating the likely clinical outcome of an individual suffering from cancer. The author gives a short review of the most important prognostic factors in breast cancer. 376 breast cancer cases of a ten year interval in a county hospital are summarized. Traditional clinico-pathological parameters i.e. TNM and steroid receptor status are discussed. The more common karyotipic, oncogene and tumor suppressor gene alterations are outlined in the study. Methods for their detection are presented and their value in prognostication is reviewed. Emphasis was laid on steroid receptors, c-erpB-2, p53 and bcl-2 alterations. Genes responsible for heritable forms of increased breast cancer risk are briefly reviewed. PMID:9608769

Vajda, K



Consequences of Growing Up Poor.  

ERIC Educational Resources Information Center

The consequences and correlates of growing up poor as well as the mechanisms through which poverty influences children are explored. This book is organized with a primary focus on research findings and a secondary concern with policy implications. The chapters are: (1) "Poor Families, Poor Outcomes: The Well-Being of Children and Youth" (Jeanne…

Duncan, Greg J., Ed.; Brooks-Gunn, Jeanne, Ed.


Consequences of Growing Up Poor.  

ERIC Educational Resources Information Center

|The consequences and correlates of growing up poor as well as the mechanisms through which poverty influences children are explored. This book is organized with a primary focus on research findings and a secondary concern with policy implications. The chapters are: (1) "Poor Families, Poor Outcomes: The Well-Being of Children and Youth" (Jeanne…

Duncan, Greg J., Ed.; Brooks-Gunn, Jeanne, Ed.


Metrics for Offline Evaluation of Prognostic Performance.  

National Technical Information Service (NTIS)

Prognostic performance evaluation has gained significant attention in the past few years. Currently, prognostics concepts lack standard definitions and suffer from ambiguous and inconsistent interpretations. This lack of standards is in part due to the va...

A. Saxena B. Saha J. Celaya K. Goebel S. Saha



Overexpression of NDRG1 is an indicator of poor prognosis in hepatocellular carcinoma  

Microsoft Academic Search

Hepatocellular carcinoma is a highly lethal cancer that typically has poor prognosis. Prognostic markers can help in its clinical management and in understanding the biology of poor prognosis. Through an earlier gene expression study, we identified N-Myc downregulated gene 1 (NDRG1) to be significantly highly expressed in hepatocellular carcinoma compared to nontumor liver. As NDRG1 is a differentiation-related gene with

Mei-Sze Chua; Hongbo Sun; Siu T Cheung; Veronica Mason; John Higgins; Douglas T Ross; Sheung T Fan; Samuel So



Expression of ezrin correlates with poor prognosis of nasopharyngeal carcinoma  

Microsoft Academic Search

A significant proportion of patients with nasopharyngeal carcinoma (NPC) will develop regional relapse or distant metastasis\\u000a after treatment. So, to find valuable prognostic factors becomes very important. To elucidate the expression of ezrin in NPC\\u000a and its correlation with patients’ clinicopathologic characteristics, time to progression, and overall survival, immunohistochemistry\\u000a stains for ezrin were applied to 200 tissue specimens of NPC.

Liang Wang; Gui-Nan Lin; Xiang-Li Jiang; Yue Lu


Molecular profiling related to poor prognosis in thyroid carcinoma. Combining gene expression data and biological information  

Microsoft Academic Search

Undifferentiated and poorly differentiated thyroid tumors are responsible for more than half of thyroid cancer patient deaths in spite of their low incidence. Conventional treatments do not obtain substantial benefits, and the lack of alternative approaches limits patient survival. Additionally, the absence of prognostic markers for well-differentiated tumors complicates patient-specific treatments and favors the progression of recurrent forms. In order

C Montero-Conde; J M Martín-Campos; E Lerma; G Gimenez; J L Martínez-Guitarte; N Combalía; D Montaner; X Matías-Guiu; J Dopazo; A de Leiva; M Robledo; D Mauricio



Prognostic factors in acute pancreatitis  

Microsoft Academic Search

Prognostic factor scoring systems provide one method of predicting severity of acute pancreatitis. This paper reports the prospective assessment of a system using nine factors available within 48 hours of admission. This assessment does not include patient data used to compile the system. Of 405 episodes of acute pancreatitis occurring in a seven year period, 72% had severity correctly predicted

S L Blamey; C W Imrie; J ONeill; W H Gilmour; D C Carter



Expression of protein tyrosine kinase 6 (PTK6) in nonsmall cell lung cancer and their clinical and prognostic significance  

PubMed Central

Aim: The aim of the study was to validate the expression of protein tyrosine kinase 6 (PTK6) in nonsmall cell lung cancer (NSCLC), and to evaluate its clinicopathological and prognostic significance. Methods: We first conducted a meta-analysis on the mRNA profiling data sets of NSCLC in the Oncomine database. Then, one of the most significantly upregulated tyrosine kinase targets, PTK6, was further validated by immunohistochemistry in 104 primary NSCLC tumors. Furthermore the association between PTK6 expression, the clinical parameters, and overall survival was further analyzed. Results: Using the Oncomine database, we identified a list of tyrosine kinase genes related to NSCLC, among which PTK6 was the second most overexpressed gene (median rank = 915, P = 2.9 × 10?5). We further confirmed that NSCLC tumors had a higher expression level of PTK6 than normal pulmonary tissues. Moreover, high PTK6 expression correlated positively with shorter overall survival time, but not with other clinicopathological characteristics. In the multivariate Cox regression model, high PTK6 expression was demonstrated to be an independent prognostic factor for NSCLC patients. Conclusion: Our results validated that PTK6 was found to be overexpressed in a proportion of NSCLC samples, and was associated with a poor prognosis, suggesting that this subgroup of NSCLC patients might benefit from PTK6 inhibitors in the future.

Zhao, Chao; Chen, Yan; Zhang, Weiwei; Zhang, Jianrong; Xu, Yulian; Li, Wenjie; Chen, Sunxiao; Deng, Anmei



Genetic prognostic markers in colorectal cancer.  

PubMed Central

The contribution of molecular genetics to colorectal cancer has been restricted largely to relatively rare inherited tumours and to the detection of germline mutations predisposing to these cancers. However, much is now also known about somatic events leading to colorectal cancer. A number of studies has been undertaken examining possible relations between genetic features and prognostic indices. While many of these studies are small and inconclusive, it is clear that a number of different pathways exist for the development of this cancer and some molecular characteristics correlate with clinicopathological features. With the advent of methods for the rapid genotyping of large numbers of colorectal cancers, it should be possible to evaluate fully the clinical usefulness of colorectal cancer genotypes through multivariate analyses.

Houlston, R S; Tomlinson, I P



Sensor Systems for Prognostics and Health Management  

PubMed Central

Prognostics and health management (PHM) is an enabling discipline consisting of technologies and methods to assess the reliability of a product in its actual life cycle conditions to determine the advent of failure and mitigate system risk. Sensor systems are needed for PHM to monitor environmental, operational, and performance-related characteristics. The gathered data can be analyzed to assess product health and predict remaining life. In this paper, the considerations for sensor system selection for PHM applications, including the parameters to be measured, the performance needs, the electrical and physical attributes, reliability, and cost of the sensor system, are discussed. The state-of-the-art sensor systems for PHM and the emerging trends in technologies of sensor systems for PHM are presented.

Cheng, Shunfeng; Azarian, Michael H.; Pecht, Michael G.



Prognostic factors in stage III non-small cell lung cancer: a review of conventional, metabolic and new biological variables  

PubMed Central

Lung cancer is one of the most frequently occurring neoplasms and usually has a poor prognosis because most of the patients present with advanced or metastatic disease at the time of diagnosis. Numerous prognostic factors (PFs) have been studied, but the two most prominent, having both prognostic and operational values, are disease stage and performance status. Even if the literature on PFs in lung cancer is impressive, the number of publications specifically dealing with PFs in stage III non-small cell lung cancer (NSCLC) is limited. We reviewed the literature on this topic and separated the available information into three groups: conventional PFs, metabolic criteria (standardized uptake value [SUV] measured on18F-FDG-PET) and new biomarkers. Performance status and the distinction between stage IIIA and IIIB confirmed their prognostic value in stage III NSCLC. Other conventional PFs have been suggested such as age, weight loss, response to treatment and some characteristics describing the locoregional extension of the tumour. There is a place for the SUV as a PF for survival in early NSCLC, but its role in stage III NSCLC has to be further assessed. Some new biomarkers involved in cell cycle regulation or in apoptosis have been shown to have potential value. Their role needs to be confirmed in large prospective studies including conventional PFs to determine their independent value as a PF in stage III NSCLC. In conclusion, few PFs have been well evaluated in stage III NSCLC. New studies, taking into account the modifications derived from the 7th international staging system of the UICC, have to be performed.

Berghmans, Thierry; Paesmans, Marianne; Sculier, Jean-Paul



The prognostic importance of different definitions of worsening renal function in congestive heart failure  

Microsoft Academic Search

Background: Worsening renal function in patients hospitalized for heart failure portends a poor prognosis. However, criteria used to define worsening renal function are arbitrary, and the implications of different definitions remain unclear. We therefore compared the prognostic importance of various definitions of worsening renal function in 1,002 patients hospitalized for congestive heart failure (CHF). Methods and Results: The patient population

Stephen S. Gottlieb; William Abraham; Javed Butler; Daniel E. Forman; Evan Loh; Barry M. Massie; Christopher M. O'Connor; Michael W. Rich; Lynne Warner Stevenson; James Young; Harlan M. Krumholz



Diagnostic and prognostic impact of six circulating microRNAs in acute coronary syndrome  

Microsoft Academic Search

Circulating microRNAs may have diagnostic potential in acute coronary syndrome (ACS). Previous studies, however, were based on low patient numbers and could not assess the relation of microRNAs to clinical characteristics and their potential prognostic value. We thus assessed the diagnostic and prognostic value of cardiomyocyte-enriched microRNAs in the context of clinical variables and a sensitive myonecrosis biomarker in a

Christian Widera; Shashi K. Gupta; Johan M. Lorenzen; Claudia Bang; Johann Bauersachs; Kerstin Bethmann; Tibor Kempf; Kai C. Wollert; Thomas Thum



Contribution of vascular endothelial growth factor to the Nottingham prognostic index in node-negative breast cancer  

PubMed Central

The prognostic contribution of intratumour VEGF, the most important factor in tumour-induced angiogenesis, to NPI was evaluated by using flexible modelling in a series of 226 N-primary breast cancer patients in which steroid receptors and cell proliferation were also accounted for. VEGF provided an additional prognostic contribution to NPI mainly within ER-poor tumours. © 2001 Cancer Research Campaign

Coradini, D; Boracchi, P; Daidone, M Grazia; Pellizzaro, C; Miodini, P; Ammatuna, M; Tomasic, G; Biganzoli, E



Poor readers in secondary school  

Microsoft Academic Search

A follow-up of a representative sample of poor readers through secondary schooling confirmed persisting reading problems for most children. As a group, poor readers fell further behind a normal-reading comparison group during their early teens. Later reading progress was unrelated to gender, SES background, behavior problems or non-school attendance, though these factors did influence wider school attainments. Poor readers were

Barbara Maughan; Ann Hagell; Michael Rutter; William Yule



Lymphopenia combined with low TCR diversity (divpenia) predicts poor overall survival in metastatic breast cancer patients  

PubMed Central

Lymphopenia (< 1Giga/L) detected before initiation of chemotherapy is a predictive factor for death in metastatic solid tumors. Combinatorial T cell repertoire (TCR) diversity was investigated and tested either alone or in combination with lymphopenia as a prognostic factor at diagnosis for overall survival (OS) in metastatic breast cancer (MBC) patients. The combinatorial TCR diversity was measured by semi quantitative multi-N-plex PCR on blood samples before the initiation of the first line chemotherapy in a development (n = 66) and validation (n = 67) MBC patient cohorts. A prognostic score, combining lymphocyte count and TCR diversity was evaluated. Univariate and multivariate analyses of prognostic factors for OS were performed in both cohorts. Lymphopenia and severe restriction of TCR diversity called “divpenia” (diversity ? 33%) were independently associated with shorter OS. Lympho-divpenia combining lymphopenia and severe divpenia accurately identified patients with poor OS in both cohorts (7.6 and 10.6 vs 24.5 and 22.9 mo). In multivariate analysis including other prognostic clinical factors, lympho-divpenia was found to be an independent prognostic factor in the pooled cohort (p = 0.005) along with lack of HER2 and hormonal receptors expression (p = 0.011) and anemia (p = 0.009). Lympho-divpenia is a novel prognostic factor that will be used to improve quality of MBC patients’ medical care.

Manuel, Manuarii; Tredan, Olivier; Bachelot, Thomas; Clapisson, Gilles; Courtier, Anais; Parmentier, Gilles; Rabeony, Tioka; Grives, Audrey; Perez, Solene; Mouret, Jean-Francois; Perol, David; Chabaud, Sylvie; Ray-Coquard, Isabelle; Labidi-Galy, Intidhar; Heudel, Pierre; Pierga, Jean-Yves; Caux, Christophe; Blay, Jean-Yves; Pasqual, Nicolas; Menetrier-Caux, Christine



Prevalence of Prognostic Biomarkers in Archival Specimens and Breast Cancer Survival Among White, Black, and Asian Women.  

National Technical Information Service (NTIS)

We assessed distributions of breast cancer tumor characteristics and molecular prognostic biomarkers by race/ethnicity and socioeconomic position among paraffin-embedded tumor biopsy specimens from 135 U.S. women (48 white, 44 black, 43 Asian) diagnosed w...

N. Krieger



Prognostic significance of Dicer cellular levels in soft tissue sarcomas.  


In the present study we assessed the expression and distribution of endoribonuclease Dicer in soft tissue tumors and correlated its cellular levels with clinicopathological parameters, including clinical outcome. Dicer was expressed in the tested cell line as well as in the majority of the sarcomas examined. Staining intensity was significantly higher in sarcomas compared with benign neoplasms and in high-grade compared with low-grade tumors. Elevated Dicer immunoreactivity was strongly associated with poor outcome and Dicer cellular levels were an independent negative prognostic factor. PMID:22149178

Papachristou, Dionysios J; Rao, Uma N M; Korpetinou, Angeliki; Giannopoulou, Efstathia; Sklirou, Emilia; Kontogeorgakos, Vasileios; Kalofonos, Haralabos P



Measuring pro-poor growth  

Microsoft Academic Search

We measure the rate of pro-poor growth by the mean growth rate of the poor, which equals the rate of change in the Watts index of poverty normalized by the headcount index. Examples are given using data for China during the 1990s.

Martin Ravallion; Shaohua Chen



Existing models, but not neutrophil-to-lymphocyte ratio, are prognostic in malignant mesothelioma.  


Background:Recent studies proposed neutrophil-to-lymphocyte ratio (NLR) as a prognostic biomarker in malignant pleural mesothelioma (MPM). We examined baseline prognostic variables including NLR and the EORTC and CALGB models as predictors of overall survival (OS) in MPM.Methods:In this retrospective study, 274 consecutive eligible, newly presenting patients with MPM were included. Of these, 159 received chemotherapy, 10 had tri-modality therapy, 2 underwent surgery only and 103 received supportive care alone. Univariate analyses and multivariate Cox models were calculated for OS.Results:In univariate analysis, poor prognostic factors were: age ?65 years, nonepithelioid histology, stage III-IV, poor performance status (PS), weight loss, chest pain, low haemoglobin and high platelet count. A baseline NLR?5 did not predict worse OS (hazard ratio (HR) 1.25; P=0.122). On multivariate analysis, age, histology, PS, weight loss, chest pain and platelet count remained significant. The EORTC and CALGB prognostic groups were validated as predictive for OS (HR 1.62; P<0.001 and HR 1.65; P<0.001, respectively).Conclusion:Our findings validate standard prognostic variables and the existing EORTC and CALGB models, but not NLR, at initial diagnosis of MPM. In guiding patient management at diagnosis, it is important to consider multiple baseline variables that jointly predict survival. PMID:23982605

Meniawy, T M; Creaney, J; Lake, R A; Nowak, A K



[Prognostic value of ventricular arrhythmias].  


In patients with heart failure ventricular arrhythmias correlate with the functional class and thus they are a marker of heart disease severity. An "independent" prognostic value of ventricular arrhythmias is generally accepted in post-infarction patients, but it is controversial in the presence of other heart diseases. According to the results of the MADIT and MUSTT studies the prognostic significance can be improved in post-infarction patients with non-sustained ventricular tachycardia during an electrophysiologic study aimed to evaluate the inducibility of sustained ventricular tachyarrhythmias with programmed electrical stimulation: in the "non-inducible" patients the prognosis is better than in "inducible" patients. Thus, we suggest to perform an electrophysiological evaluation in post-infarction patients and in patients with non-sustained ventricular tachycardia. PMID:11838350

Vergara, G



Prognostic indicators in pituitary tumors  

Microsoft Academic Search

Recent advances in molecular pathology have shed light not only on the cellular composition and derivation of various tumors,\\u000a but also on their growth potential, likelihood of recurrence, and prognosis. The development of reliable and prognostically\\u000a informative methods of assessing tumor behavior is particularly important in pituitary tumors, where no precise correlation\\u000a exists between morphology and clinical aggressiveness. Among the

Agustinus Suhardja; Kalman Kovacs; Oded Greenberg; Bernd W. Scheithauer; Ricardo V. Lloyd



A gene sets approach for identifying prognostic gene signatures for outcome prediction  

PubMed Central

Background Gene expression profiling is a promising approach to better estimate patient prognosis; however, there are still unresolved problems, including little overlap among similarly developed gene sets and poor performance of a developed gene set in other datasets. Results We applied a gene sets approach to develop a prognostic gene set from multiple gene expression datasets. By analyzing 12 independent breast cancer gene expression datasets comprising 1,756 tissues with 2,411 pre-defined gene sets including gene ontology categories and pathways, we found many gene sets that were prognostic in most of the analyzed datasets. Those prognostic gene sets were related to biological processes such as cell cycle and proliferation and had additional prognostic values over conventional clinical parameters such as tumor grade, lymph node status, estrogen receptor (ER) status, and tumor size. We then estimated the prediction accuracy of each gene set by performing external validation using six large datasets and identified a gene set with an average prediction accuracy of 67.55%. Conclusion A gene sets approach is an effective method to develop prognostic gene sets to predict patient outcome and to understand the underlying biology of the developed gene set. Using the gene sets approach we identified many prognostic gene sets in breast cancer.

Kim, Seon-Young; Kim, Yong Sung



Stromal tenascin distribution as a prognostic marker in colorectal cancer.  

PubMed Central

A total of 169 colorectal adenocarcinomas, obtained from patients with a median follow-up of 6.5 years, were studied with immunohistochemical staining on cryosections using a monoclonal anti-tenascin antibody to evaluate the possible association between the staining patterns and tumour stage, tumour differentiation and survival. We found two different staining patterns in the tumour stroma--a diffuse stromal fibrillar staining in 92 out of 169 (54%) tumours and a subglandular staining in the remaining 77 tumours. When the entire group of patients (P < 0.01) and the group of potentially cured patients (P < 0.03) were analysed univariately, it was found that diffuse stromal fibrillar staining was associated with a shorter survival time than subglandular staining. In a multivariate analysis, the Dukes' stage and age were independent prognostic factors, whereas the tenascin expression did not retain a clear independent relationship to survival (P = 0.06). Hence, it appears that the tumour expression of tenascin may be a potential prognostic marker in colorectal cancer, in so far as a diffuse stromal fibrillar staining pattern seems to indicate an increased risk of poor outcome. However, after adjustment for age and Dukes' stage, the additional prognostic value of tenascin remains to be established in further analyses. Images Figure 1

Kressner, U.; Lindmark, G.; Tomasini-Johansson, B.; BergstrA?m, R.; Gerdin, B.; PA?hlman, L.; Glimelius, B.



Feline mammary adenocarcinoma: tumor size as a prognostic indicator  

PubMed Central

Mammary carcinomas and adenocarcinomas (MACs) are relatively common tumors in cats. The postexcisional survival period of affected cats is inversely proportional to tumor size, but the reported median survival periods for different tumor size categories is quite variable. This variability diminishes the prognostic value of reported data. In our study, cats with MACs greater than 3 cm in diameter had a 12-month median survival period, whereas those with MACs less than 3 cm in diameter had a 21-month survival period. Survival periods for cats with MACs smaller than 3 cm ranged from 3 to 54 months; therefore, tumor size alone is of limited prognostic value in cats with MACs smaller than 3 cm in diameter. In cats with MACs larger than 3 cm in diameter, tumor size appears to have much higher prognostic relevance, because this study, as well as others, have indicated that cats with MACs greater than 3 cm in diameter have a poor prognosis, with median survival periods ranging from 4 to 12 months.

Viste, Jodi R.; Myers, Sherry L.; Singh, Baljit; Simko, Elemir



Prognostic role of pneumonia in supracricoid and supraglottic laryngectomies.  


The goal of this study was to identify host and tumour factors associated with postoperative pneumonia (PP) in a selected population of laryngeal cancer patients, treated by partial laryngectomy in 20 years at our Institution and to assess its potential prognostic impact. Clinical records of 416 consecutive patients were retrospectively reviewed. Tobacco consumption, body mass index (BMI), previous pulmonary disease, age, sex, preoperative blood gas analysis values, tumour stage and type of surgery were tested as potential risk factors for PP. Finally, the prognostic impact of these variables, including PP, in terms of disease-free and actuarial survival by Kaplan-Meier and Cox analyses were evaluated. PP developed in 73 patients (16.8%). We identified two groups of patients: 26 patients experienced an early PP within the first 7-9 days after surgery, whilst 44 experienced an ab ingestis PP following attempts of oral food intake restoration, three patients died for PP related sepsis. At multivariate Cox analysis, age older than 60 years and BMI greater than 30 were statistically associated with early PP; whereas male gender and laryngectomy with neck dissection were statistically related to a higher risk of ab ingestis PP. Interestingly, the occurrence of early PP was a negative independent prognostic factor for 5-years disease-free and actuarial survival (p=0.049 and p=0.001, respectively). The occurrence of early-onset pneumonia in laryngeal cancer patients selected for conservative laryngectomies is predictable and associated with poor clinical outcome. PMID:18620892

Gallo, O; Deganello, A; Gitti, G; Santoro, R; Senesi, M; Scala, J; Boddi, V; De Campora, E



The prognostic value of the nodal ratio in N1 breast cancer  

PubMed Central

Background Although the nodal ratio (NR) has been recognized as a prognostic factor in breast cancer, its clinical implication in patients with 1-3 positive nodes (N1) remains unclear. Here, we evaluated the prognostic value of the NR and identified other clinico-pathologic variables associated with poor prognosis in these patients. Methods We analyzed 130 patients with N1 invasive breast cancer who were treated at Seoul National University Bundang Hospital from March 2003 to December 2007. Disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) were compared according to the NR with a cut-off value of 0.15. Results We followed patients' recovery for a median duration of 59 months. An NR > 0.15 was found in 23.1% of patients, and a median of 18 nodes were dissected per patient (range 1-59). The NR was statistically independent from other prognostic variables, such as patient age, T stage, extent of surgery, pathologic factors in the chi square test. On univariate analysis, patients with a NR > 0.15 had significantly lower 5-year LRRFS (88.7% vs. 97.9%, p = 0.033) and 5-year DMFS (81.3% vs. 96.4%, p = 0.029) and marginally lower 5-year DFS (81.3% vs. 94.0%, p = 0.069) than those with a NR ?0.15, respectively. Since the predictive power of the NR was found to differ with diverse clinical and pathologic variables, we performed adjusted analysis stratified by age, pathologic characteristics, and adjuvant treatments. Only young patients with a NR > 0.15 showed significantly lower DFS (p = 0.027) as well as those presenting an unfavorable pathologic profile such as advanced T stage (p = 0.034), histologic grade 3 (p = 0.034), positive lymphovascular invasion (p = 0.037), involved resection margin (p = 0.007), and no chemotherapy (p = 0.014) or regional radiotherapy treatment (p = 0.039). On multivariate analysis, a NR > 0.15 was significantly associated with lower DFS (p = 0.043) and DMFS (p = 0.012), but not LRRFS (p = 0.064). Conclusions A NR > 0.15 was associated with an increased risk of recurrence, especially in young patients with unfavorable pathologic profiles.



Prognostic Value of HIFs Expression in Head and Neck Cancer: A Systematic Review  

PubMed Central

Background Tumor hypoxia plays a fundamental role in resistance to therapy and disease progression. A number of studies have assessed the prognostic role of HIFs expression in head and neck cancer (HNC), but no consistent outcomes are reported. Methodology A systematical search was performed to search relevant literatures in PubMed, Web of Science and ISI Web of Knowledge databases. The patients’ clinical characteristics and survival outcome were extracted. The correlation between HIFs expression and prognosis was analyzed. Principal Findings A total of 28 studies assessed the association between HIFs and HNC survival, the result showed that overexpressed HIFs was significantly associated with increase of mortality risk (HR?=?2.12; 95% CI: 1.52–2.94; I2 74%). Subgroup analysis on different HIF isoforms with OS indicated that both HIF-1? and HIF-2? were associated with worse prognosis. The pooled HRs were 1.72(95% CI 1.34–2.20; I2 70.7%) and 1.79(95% CI: 1.42–2.27, I2 0%). Further subgroup analysis was performed by different geographical locations, disease subtype, stage, types of variate analysis and cut-off value. The results revealed that overexpressed HIF-1? was significantly associated with poor prognosis in Asian patients (HR?=?2.34; 95% CI: 1.76–3.1; I2 48.9%), but not in European patients (HR?=?1.13; 95% CI: 0.77–1.66; I2 78.3%). Furthermore, HIF-1? overexpression was significantly associated with worse OS in oral carcinoma(HR?=?2.1; 95% CI: 1.11–3.97; I2 81.7%), nasopharyngeal carcinoma(HR?=?2.07; 95% CI:1.23–3.49; I2 22.5%) and oropharynx carcinoma(HR?=?1.76; 95% CI:1.05–2.97; I2 61%), but not in laryngeal carcinoma(HR?=?1.38; 95% CI: 0.87–2.19; I2 62.5%). We also found that the prognostic value of HIF-1? overexpression existed only when using staining and percentage as positive definition (HR?=?1.82; 95% CI 1.42–2.33; I2 9.9%). Conclusions This study showed that overexpressed HIFs were significantly associated with increase of mortality risk. Subgroup analysis revealed that overexpressed HIF-1? was significantly associated with worse prognosis of HNC in Asian countries. Additionally, HIF-1? had different prognostic value in different HNC disease subtypes.

Zhou, Jianding; Lu, Jie; Xiong, Hua; Shi, Xueli; Chen, Jianqiang



Histocompatibility Antigen-Poor Blood.  

National Technical Information Service (NTIS)

A number of methods for the production of leukocyte poor blood were evaluated including nylon filtration, differential sedimentation, dextran sedimentation and combinations of these methods. The use of nylon fiber Leukopack followed by inverted centrifuga...

W. V. Miller



Trace elements as tumor biomarkers and prognostic factors in breast cancer: a study through energy dispersive x-ray fluorescence  

PubMed Central

Background The application and better understanding of traditional and new breast tumor biomarkers and prognostic factors are increasing due to the fact that they are able to identify individuals at high risk of breast cancer, who may benefit from preventive interventions. Also, biomarkers can make possible for physicians to design an individualized treatment for each patient. Previous studies showed that trace elements (TEs) determined by X-Ray Fluorescence (XRF) techniques are found in significantly higher concentrations in neoplastic breast tissues (malignant and benign) when compared with normal tissues. The aim of this work was to evaluate the potential of TEs, determined by the use of the Energy Dispersive X-Ray Fluorescence (EDXRF) technique, as biomarkers and prognostic factors in breast cancer. Methods By using EDXRF, we determined Ca, Fe, Cu, and Zn trace elements concentrations in 106 samples of normal and breast cancer tissues. Cut-off values for each TE were determined through Receiver Operating Characteristic (ROC) analysis from the TEs distributions. These values were used to set the positive or negative expression. This expression was subsequently correlated with clinical prognostic factors through Fisher’s exact test and chi-square test. Kaplan Meier survival curves were also evaluated to assess the effect of the expression of TEs in the overall patient survival. Results Concentrations of TEs are higher in neoplastic tissues (malignant and benign) when compared with normal tissues. Results from ROC analysis showed that TEs can be considered a tumor biomarker because, after establishing a cut-off value, it was possible to classify different tissues as normal or neoplastic, as well as different types of cancer. The expression of TEs was found statistically correlated with age and menstrual status. The survival curves estimated by the Kaplan-Meier method showed that patients with positive expression for Cu presented a poor overall survival (p?prognostic factors for breast cancer. The element copper also showed statistical correlation with overall survival.



Cortisol as a Prognostic Marker of Short-Term Outcome in Chinese Patients with Acute Ischemic Stroke  

PubMed Central

Background Early prediction of outcome is important for allocation of therapeutic strategies. Endocrine alterations of the hypothalamus–pituitary–axis are one of the first stress-induced alterations after cerebral ischemia. We therefore evaluated the prognostic value of serum cortisol in Chinese patients with an acute ischemic stroke. Methods In a prospective observational study, serum cortisol was measured using a solid-phase, competitive chemiluminescent enzyme immunoassay on admission in serum of 226 consecutive Chinese patients with an acute ischemic stroke. The prognostic value of serum cortisol to predict the functional outcome, mortality within 90 days, was compared with clinical variables (e.g., advanced age and the National Institutes of Health Stroke Scale [NHISS] score) and with other known predictors. Results Patients with a poor outcome and nonsurvivors had significantly increased serum cortisol levels on admission (P<0.0001, P<0.0001). There was a positive correlation between levels of cortisol and the NIHSS (r?=?0.298, P<0.0001), glucose levels (r?=?0.324, P<0.0001) and infarct volume (r?=?0.328, P<0.0001). Cortisol was an independent prognostic marker of functional outcome and death [odds ratio 3.44 (2.58–6.23) and 4.21 (1.89–9.24), respectively, P<0.0001 for both, adjusted for age, the NIHSS and other predictors] in patients with ischemic stroke. In receiver operating characteristic curve analysis, cortisol could improve the NIHSS score in predicting short-term functional outcome (Area under the curve [AUC] of the combined model, 0.87; 95% CI, 0.82–0.92; P?=?0.01) and mortality (AUC of the combined model, 0.90; 95% CI, 0.84–0.95; P?=?0.01). Conclusion Cortisol can be seen as an independent short-term prognostic marker of functional outcome and death in Chinese patients with acute ischemic stroke even after correcting confounding factors. Combined model can add significant additional predictive information to the clinical score of the NIHSS.

Zi, Wen-Jie; Shuai, Jie



Stem cell-associated genes are extremely poor prognostic factors for soft-tissue sarcoma patients.  


Cancer stem cells can play an important role in tumorigenesis and tumor progression. However, it is still difficult to detect and isolate cancer stem cells. An alternative approach is to analyse stem cell-associated gene expression. We investigated the coexpression of three stem cell-associated genes, Hiwi, hTERT and survivin, by quantitative real-time-PCR in 104 primary soft-tissue sarcomas (STS). Multivariate Cox's proportional hazards regression analyses allowed correlating gene expression with overall survival for STS patients. Coexpression of all three stem cell-associated genes resulted in a significantly increased risk of tumor-related death. Importantly, tumors of patients with the poorest prognosis were of all four tumor stages, suggesting that their risk is based upon coexpression of stem cell-associated genes rather than on tumor stage. PMID:17525744

Taubert, H; Würl, P; Greither, T; Kappler, M; Bache, M; Bartel, F; Kehlen, A; Lautenschläger, C; Harris, L C; Kaushal, D; Füssel, S; Meye, A; Böhnke, A; Schmidt, H; Holzhausen, H-J; Hauptmann, S



Stem cell-associated genes are extremely poor prognostic factors for soft-tissue sarcoma patients  

Microsoft Academic Search

Cancer stem cells can play an important role in tumorigenesis and tumor progression. However, it is still difficult to detect and isolate cancer stem cells. An alternative approach is to analyse stem cell-associated gene expression. We investigated the coexpression of three stem cell-associated genes, Hiwi, hTERT and survivin, by quantitative real-time–PCR in 104 primary soft-tissue sarcomas (STS). Multivariate Cox's proportional

H Taubert; P Würl; T Greither; M Kappler; M Bache; F Bartel; A Kehlen; C Lautenschläger; L C Harris; D Kaushal; S Füssel; A Meye; A Böhnke; H Schmidt; H-J Holzhausen; S Hauptmann



Prognostic stratification of patients with advanced renal cell carcinoma treated with sunitinib: comparison with the Memorial Sloan-Kettering prognostic factors model  

Microsoft Academic Search

BACKGROUND: The treatment paradigm in advanced renal cell carcinoma (RCC) has changed in the recent years. Sunitinib has been established as a new standard for first-line therapy. We studied the prognostic significance of baseline characteristics and we compared the risk stratification with the established Memorial Sloan Kettering Cancer Center (MSKCC) model. METHODS: This is a retrospective analysis of patients treated

Aristotelis Bamias; Alexandra Karadimou; Sofia Lampaki; George Lainakis; Lia Malettou; Eleni Timotheadou; Kostas Papazisis; Charalambos Andreadis; Loukas Kontovinis; Ioannis Anastasiou; Kostas Stravodimos; Ioannis Xanthakis; Andreas Skolarikos; Christos Christodoulou; Kostas Syrigos; Christos Papandreou; Evangelia Razi; Urania Dafni; George Fountzilas; Meletios A Dimopoulos



High Expression of Testes-Specific Protease 50 Is Associated with Poor Prognosis in Colorectal Carcinoma  

PubMed Central

Background Testes-specific protease 50 (TSP50) is normally expressed in testes and abnormally expressed in breast cancer, but whether TSP50 is expressed in colorectal carcinoma (CRC) and its clinical significance is unclear. We aimed to detect TSP50 expression in CRC, correlate it with clinicopathological factors, and assess its potential diagnostic and prognostic value. Methodology/Principal Findings TSP50 mRNAs and proteins were detected in 7 CRC cell lines and 8 CRC specimens via RT-PCR and Western blot analysis. Immunohistochemical analysis of TSP50, p53 and carcinoembryonic antigen (CEA) with tissue microarrays composed of 95 CRCs, 20 colorectal adenomas and 20 normal colorectal tissues were carried out and correlated with clinicopathological characteristics and disease-specific survival for CRC patients. There was no significant correlation between the expression levels of TSP50 and p53 (P?=?0.751) or CEA (P?=?0.663). Abundant expression of TSP50 protein was found in CRCs (68.4%) while it was poorly expressed in colorectal adenomas and normal tissues (P<0.0001). Thus, CRCs can be distinguished from them with high specificity (92.5%) and positive predictive value (PPV, 95.6%). The survival of CRC patients with high TSP50 expression was significantly shorter than that of the patients with low TSP50 expression (P?=?0.010), specifically in patients who had early-stage tumors (stage I and II; P?=?0.004). Multivariate Cox regression analysis indicated that high TSP50 expression was a statistically significant independent risk factor (hazard ratio ?=?2.205, 95% CI?=?1.214–4.004, P?=?0.009). Conclusion Our data demonstrate that TSP50 is a potential effective indicator of poor survival for CRC patients, especially for those with early-stage tumors.

Duan, Guangjie; Yan, Xiaochu; Li, Qianwei



Analysis of and prognostic information from disseminated tumour cells in bone marrow in primary breast cancer: a prospective observational study  

PubMed Central

Background Disseminated tumour cells (DTCs) in the bone marrow of patients with breast cancer have been identified as an independent predictor of poor prognosis in patients with non-metastatic disease. This prospective study aimed to evaluate the presence and prognostic value of DTCs in the bone marrow of female patients with primary breast cancer. Methods Between 1999 and 2003, bone marrow aspirates were obtained from patients at the time of surgery for primary invasive breast cancer. DTCs in bone marrow were identified using monoclonal antibodies against cytokeratins for detection of epithelial cells. The detection of DTCs was related to clinical follow-up with distant disease-free survival (DDFS) and breast cancer-specific survival as endpoints. Bone marrow aspirates from adult healthy bone marrow donors were analysed separately. Results DTCs were analysed in 401 patients, and cytokeratin-positive cells were found in 152 of these (38%). An immunofluorescence (IF) staining procedure was used in 327 patients, and immunocytochemistry (IC) was performed in 74 patients. The IF-based method resulted in 40% DTC-positive cases, whereas 30% were positive using IC (p?=?0.11). The presence of DTCs in bone marrow was not significantly related to patient or tumour characteristics. The presence of DTCs was not a prognostic factor for DDFS (IF: hazards ratio [HR], 2.2; 95% confidence interval [CI], 0.63–2.2; p?=?0.60; IC: HR, 0.84; 95% CI, 0.09–8.1; p?=?0.88). Significant prognostic factors were lymph node metastases, oestrogen receptor positivity, Nottingham histological grade, and tumour size using Cox univariate analysis. The analyses were positive for epithelial cells in bone marrow from adult healthy donors in 19 (25%) samples. Conclusions The detection of DTCs in bone marrow in primary breast cancer was previously shown to be a predictor of poor prognosis. We were not able to confirm these results in a prospective cohort including unselected patients before the standard procedure was established. Future studies with a standardised patient protocol and improved technique for isolating and detecting DTCs may reveal the clinical applications of DTC detection in patients with micrometastases in the bone marrow.



[The Prognostic Value of Micrometastasis in Non-small Cell Lung Cancer].  


Lung cancer ranks top in morbidity and mortality among the malignancies in China. Non-small cell lung cancer (NSCLC) accounts for about 80%-85% of all lung malignancies. The stage at diagnosis is the principal prognostic indicator, and accurate staging is essential for treatment decisions. After radical surgical resection in patients with stage I disease, the recurrence rate ranges from 25% to 30%. Patients with a poor outcome may have occult locoregional and/or distant metastasis before resection. In recent years, there are a lot of researches aimingat detecting micrometastasis and evaluating the prognostic value of it. This study reviewed the prognostic value of micrometastasis in lymph node, bone marrow, pleural cavity and peripheral blood. PMID:24034998

Lei, Yuanyuan; Wu, Yilong



Prognostic value of Waldeyer's ring involvement of diffuse large B-cell lymphoma treated with R-CHOP.  


The objective of present study was to compare the prognosis of diffuse large B-cell lymphoma (DLBCL) with Waldeyer's ring involvement (WR-DLBCL) to that of nodal DLBCL (N-DLBCL) without WR involvement. Between July 2004 and October 2009, medical records and metabolic tumor volume (MTV) measured by 2-[fluorine-18]-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography /computed tomography were collected from patients confirmed with DLBCL. All patients received six or eight cycles of R-CHOP therapy. One hundred and eight patients were included and categorized into WR-DLBCL and N-DLBCL groups. WR involvement and other prognostic factors were analyzed for survivals. High international prognostic index score and high MTV were independent poor prognostic factors. However, WR involvement was a good prognostic factor only in univariate analysis. This study suggests that tumor burden appeared to be more important than specific organ involvement for the prognosis of DLBCL. PMID:23400410

Oh, Min-Young; Chung, Joo-Seop; Song, Moo-Kon; Shin, Ho-Jin; Lee, Ho-Sup; Lee, Sang-Min; Lee, Gyeong-Won; Lee, Su-Ee



Benefits analysis of prognostics in systems  

Microsoft Academic Search

Prognostics and health management (PHM) is a methodology that permits the reliability of a system to be evaluated in its actual life cycle conditions in order to predict when and where failures will occur and to mitigate system risks. In this paper we discuss the benefits of prognostics in systems. These benefits relate to system design and development, reliability, safety,

Bo Sun; Shengkui Zeng; Rui Kang; Michael Pecht



Blue metal-poor stars  

NASA Astrophysics Data System (ADS)

We review the discovery of blue metal-poor (BMP) stars and the resolution of this population into blue stragglers and intermediate-age Main-Sequence stars by use of binary fractions. We show that the specific frequencies of blue stragglers in the halo field and in globular clusters differ by an order of magnitude. We attribute this difference to the different modes of production of these two populations. We report carbon and s-process enrichment among very metal-poor field blue stragglers and discuss how this result can be used to further resolve field blue stragglers into groups formed during RGB and AGB evolution of their erstwhile primary companions.

Preston, George W.; Sneden, Christopher



Prognostic molecular markers in cancer - quo vadis?  


Despite the tremendous number of studies of prognostic molecular markers in cancer, only a few such markers have entered clinical practise. The lack of clinical prognostic markers clearly reflects limitations in or an inappropriate approach to prognostic studies. This situation should be of great concern for the research community, clinicians and patients. In the present review, we evaluate immunohistochemical prognostic marker studies in oral squamous cell carcinomas (OSCC) from 2006 to 2012. We comment upon general issues such as study design, assay methods and statistical methods, applicable to prognostic marker studies irrespective of cancer type. The three most frequently studied markers in OSCC are reviewed. Our analysis revealed that most new molecular markers are reported only once. To draw conclusions of clinical relevance based on the few markers that appeared in more than one study was problematic due to between-study heterogeneity. Currently, much valuable tissue material, time and money are wasted on irrelevant studies. PMID:23837466

Søland, Tine M; Brusevold, Ingvild J



Lack of MMP-9 expression is a marker for poor prognosis in Dukes' B colorectal cancer  

PubMed Central

Background Matrix metalloproteinases (MMPs) play a role in cancer progression by degrading extracellular matrix and basement membranes, assisting in tumour neovascularization and in supporting immune response in cancer. Methods We studied the prognostic value of immunohistochemical expression of MMP-2, MMP-8, and MMP-9 in a series of 619 colorectal cancer patients using tissue microarray specimens. Results Of the samples, 56% were positive for MMP-2, 78% for MMP-8, and 60% for MMP-9. MMP-9 associated with low WHO grade (p?poor survival (p?=?0.018), and MMP-9 positivity was an independent prognostic marker in multivariate analysis of these tumours (p?=?0.034). Conclusion Negative MMP-9 expression can predict poor prognosis in Dukes’ B colorectal tumours and may prove useful for identifying patients, who should be offered adjuvant treatment.



Risk for poor outcomes in older patients discharged from an emergency department: feasibility of four screening instruments  

Microsoft Academic Search

Objectives: To compare the prognostic value of four screening instruments used to detect the risk for poor outcomes [in terms of likelihood of recurrent emergency department (ED) visits, hospitalizations, or mortality] for older patients discharged home from an ED in the Netherlands. Methods: This is a prospective cohort study, which included all consecutive patients of at least 65 years discharged

B. M. Buurman; W. van den Berg; J. C. Korevaar; K. Milisen; R. J. de Haan; S. E. de Rooij



Prospects for the Working Poor  

ERIC Educational Resources Information Center

Based on a chapter entitled "Barriers to Employment of the Disadvantaged by Martin Deutsch and S. M. Miller in "Manpower Report of the President, 1968. Discusses the Nixon proposals for remediating poverty in relation to the socioeconomic factors operating to maintain the condition of being poor while working. (JM)

Miller, S. M.



Who Better Targets the Poor?  

Microsoft Academic Search

Poverty has a spatial component. There are not only impoverished people, but also impoverished places, such as slums and marginalised farming areas. According to Dreze and Sen (1989), one of the strategies to alleviate poverty, involves improving the access to consumption of the poor in the short term through income redistribution. Recently there has been a lot of debate over

Taruna Shalini Ramessur-Seenarain


Prospects for the Working Poor  

ERIC Educational Resources Information Center

|Based on a chapter entitled "Barriers to Employment of the Disadvantaged by Martin Deutsch and S. M. Miller in "Manpower Report of the President, 1968. Discusses the Nixon proposals for remediating poverty in relation to the socioeconomic factors operating to maintain the condition of being poor while working. (JM)|

Miller, S. M.



Poor Memory: A Case Report.  

ERIC Educational Resources Information Center

|Presents a case study of a person who had a cardiac arrest with some right-sided brain damage. Describes the effects of poor memory on cognition, personality, and interpersonal relationships based on personal observations during memory impairment. Highlights the course of rehabilitation over a two-year period. (PAS)|

Meltzer, Malcolm L.



A prognostic gene expression signature in infratentorial ependymoma.  


Patients with ependymoma exhibit a wide range of clinical outcomes that are currently unexplained by clinical or histological factors. Little is known regarding molecular biomarkers that could predict clinical behavior. Since recent data suggest that these tumors display biological characteristics according to their location (cerebral vs. infratentorial vs. spinal cord), rather than explore a broad spectrum of ependymoma, we focused on molecular alterations in ependymomas arising in the infratentorial compartment. Unsupervised clustering of available gene expression microarray data revealed two major subgroups of infratentorial ependymoma. Group 1 tumors over expressed genes that were associated with mesenchyme, Group 2 tumors showed no distinct gene ontologies. To assess the prognostic significance of these gene expression subgroups, real-time reverse transcriptase polymerase chain reaction assays were performed on genes defining the subgroups in a training set. This resulted in a 10-gene prognostic signature. Multivariate analysis showed that the 10-gene signature was an independent predictor of recurrence-free survival after adjusting for clinical factors. Evaluation of an external dataset describing subgroups of infratentorial ependymomas showed concordance of subgroup definition, including validation of the mesenchymal subclass. Importantly, the 10-gene signature was validated as a predictor of recurrence-free survival in this dataset. Taken together, the results indicate a link between clinical outcome and biologically identified subsets of infratentorial ependymoma and offer the potential for prognostic testing to estimate clinical aggressiveness in these tumors. PMID:22322993

Wani, Khalida; Armstrong, Terri S; Vera-Bolanos, Elizabeth; Raghunathan, Aditya; Ellison, David; Gilbertson, Richard; Vaillant, Brian; Goldman, Stewart; Packer, Roger J; Fouladi, Maryam; Pollack, Ian; Mikkelsen, Tom; Prados, Michael; Omuro, Antonio; Soffietti, Riccardo; Ledoux, Alicia; Wilson, Charmaine; Long, Lihong; Gilbert, Mark R; Aldape, Ken



Course and Prognostic Factors for Neck Pain in the General Population  

PubMed Central

Study Design Best evidence synthesis. Objective To undertake a best evidence synthesis on course and prognosis of neck pain and its associated disorders in the general population. Summary of Background Data Knowing the course of neck pain guides expectations for recovery. Identifying prognostic factors assists in planning public policies, formulating interventions, and promoting lifestyle changes to decrease the burden of neck pain. Methods The Bone and Joint Decade 2000 –2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Findings fromstudiesmeeting criteria for scientific validity were abstracted into evidence tables and included in a best evidence synthesis. Results We found 226 articles on the course and prognostic factors in neck pain and its associated disorders. After critical review, 70 (31) of these were accepted on scientific merit. Six studies related to course and 7 to prognostic factors in the general population. Between half and three quarters of persons in these populations with current neck pain will report neck pain again 1 to 5 years later. Younger age predicted better outcome. General exercise was unassociated with outcome, although regular bicycling predicted poor outcome in 1 study. Psychosocial factors, including psychologic health, coping patterns, and need to socialize, were the strongest prognostic factors. Several potential prognostic factors have not been well studied, including degenerative changes, genetic factors, and compensation policies. Conclusion The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for this symptom. General exercise was not prognostic of better outcome; however, several psychosocial factors were prognostic of outcome.

Hogg-Johnson, Sheilah; van der Velde, Gabrielle; Haldeman, Scott; Holm, Lena W.; Carragee, Eugene J.; Hurwitz, Eric L.; Cote, Pierre; Nordin, Margareta; Peloso, Paul M.; Guzman, Jaime; Cassidy, J. David



The utilization of immunohistochemical prognostic factor in endometrial adenocarcinoma: is it cost effective?  


This study investigated the relation between immunohistochemical prognostic factors and clinical stage and histopathological grade in endometrial adenocarcinoma. Twenty-seven patients with a mean age of 61 (38-74), who underwent radical surgery due to endometrial adenocarcinoma in our hospital between 1983-1998, were re-evaluated. For clinical staging FIGO criteria were used. Histopathological differentiation of the tumor was graded as good (grade 1), moderate (grade 2), and poor (grade 3). Estrogen and progesterone receptors, c-erb B2, UEA 1, Ki-67, PCNA and p53 were studied as immunohistochemical prognostic factors. There were no patients in stages IA and IIIB. Among the prognostic factors, PCNA was the most significantly stained marker, followed by c-erb B2, estrogen and progesterone receptors, regardless of the clinical stage and histopathological grade of the tumor. The least positivity was achieved with Ki-67. There was no significant difference when each prognostic factor was analysed with respect to clinical stage and histopathological grade. In our study no significant relation was found between the prognostic factors and the clinical stage and histopathological differentiation of the tumor. Therefore the cost effectiveness of the utilization of these factors should be reconsidered. PMID:10843486

Gürer, I E; Sim?ek, T; Erdo?an, G; Atalay, E; Zorlu, C G; Karaveli, S; Erman, O



Prognostic Implication of 15-Hydroxyprostaglandin Dehydrogenase Down-Regulation in Patients with Colorectal Cancer  

PubMed Central

Purpose Prostaglandin (PG) E2 is known to be closely related to cancer progression and is inactivated by 15-hydroxyprostaglandin dehydrogenase (PGDH). 15-PGDH is shown to have tumor suppressor activity and to be down-regulated in various cancers, including colorectal cancer (CRC). Therefore, we evaluated the expression of 15-PGDH and its prognostic effect in patients with CRC. Methods 15-PGDH expression was examined by using immunohistochemistry in 77 patients with CRC. Its prognostic significance was statistically evaluated. Results Negative 15-PGDH expression was noted in 55.8% of the 77 cases of CRC. 15-PGDH expression showed no correlation with any of the various clinicopathologic parameters. The status of lymph node metastasis, tumor-node-metastasis stages, and pre-operative carcinoembryonic antigen levels showed significant prognostic effect. However, univariate analysis revealed down-regulation of 15-PGDH not to be a predictor of poor survival. The 5-year overall survival rate was 71.7% in the group with positive expression of 15-PGDH and 67.1% in the group with negative expression of 15-PGDH, but this difference was not statistically significant (P = 0.751). Conclusion 15-PGDH was down-regulated in 55.8% of the colorectal cancer patients. However, down-regulation of 15-PGDH showed no prognostic value in patients with CRC. Further larger scale or prospective studies are needed to clarify the prognostic effect of 15-PGDH down-regulation in patients with colorectal cancer.

Kang, Pil Sung; Kim, Jin Ha; Moon, Ok In; Lim, Sung Chul



Prognostic implications of qualitative assessment of left ventricular function compared to simple routine quantitative echocardiography.  

PubMed Central

OBJECTIVE: To compare the prognostic value of qualitative estimates of left ventricular function with that of routine simple quantitative indices used in echocardiography. DESIGN: Retrospective follow up study. SETTING: University hospital. PATIENTS: The records of 2,964 patients who had undergone echocardiography and who could be traced on the family health services register were examined; 919 cases were included in the study, and a further 458 were used to validate the statistical models for prognostic assessment. There were 928 exclusions on the basis of referral for or diagnosis of alternative conditions, and 659 because of incomplete collection of the qualitative and quantitative data used in the study. MAIN OUTCOME MEASURE: Survival over the study period. RESULTS: A qualitative "eyeball" estimate of left ventricular function was of prognostic significance (relative risk of poor v good, 2.248; P << 0.001; 95% confidence interval 1.620 to 3.119). None of the quantitative echocardiographic indices was of independent prognostic significance when all variables were tested simultaneously in the regression model. CONCLUSIONS: A qualitative echocardiographic estimate of left ventricular dysfunction is of prognostic value, supporting the view of many cardiologists who use their overall impression of left ventricular function at echocardiography as the basis for treatment decisions.

Silcocks, P. B.; Munro, J. F.; Steeds, R. P.; Channer, K. S.



Prognostic value of (18)f-fluorodeoxyglucose positron emission tomography in patients with resectable pancreatic cancer.  


Purpose: We evaluated the prognostic value of (18)F-2-fluoro-2-deoxyglucose positron emission tomography (FDG PET) in patients with resectable pancreatic cancer. Materials and Methods: We retrospectively reviewed the medical records of pancreatic cancer patients who underwent curative resection, which included 64 consecutive patients who had preoperative FDG PET scans. For statistical analysis, the maximal standardized uptake value (SUVmax) of primary pancreatic cancer was measured. Survival time was estimated by the Kaplan-Meier method, and Cox's proportional hazard model was used to determine whether SUVmax added new predictive information concerning survival together with known prognostic factors. p<0.05 indicated statistical significance. Results: Overall survival (OS) and disease- free survival (DFS) were respectively 42.9 months (27.6-58.2; 95% CI) and 14.9 months (10.1-19.7; 95% CI). When subjects were divided into two groups according to SUVmax with a cutoff value of 3.5, the high SUVmax group (n=32; SUVmax >3.5) showed significantly shorter OS and DFS than the low SUVmax group. Multivariate analysis of OS and DFS showed that both high SUVmax and poor tumor differentiation were independent poor prognostic factors. Conclusion: Our study showed that degree of FDG uptake was an independent prognostic factor in pancreatic cancer patients who underwent curative resection. PMID:24142641

Choi, Hye Jin; Kang, Chang Moo; Lee, Woo Jung; Song, Si Young; Cho, Arthur; Yun, Mijin; Lee, Jong Doo; Kim, Joo Hang; Lee, Jae-Hoon



High CIP2A immunoreactivity is an independent prognostic indicator in early-stage tongue cancer  

PubMed Central

Background: No reliable prognostic markers exist for squamous cell carcinoma of the tongue, and its prognosis can even in early stages be unpredictable and survival poor despite treatment. A potential marker is oncoprotein cancerous inhibitor of PP2A (CIP2A), which acts as a prognostic marker in gastric and non-small cell lung cancers. Methods: We collected specimens of 73 stage T1N0M0 and T2N0M0 oral squamous cell carcinomas of the tongue, as well as samples from normal oral mucosa, dysplastic lesions, and invasive carcinomas (n=39). All samples were stained for CIP2A by immunohistochemistry. Survival curves were constructed according to the Kaplan–Meier method. The Cox proportional hazard model served for univariate and multivariate survival analysis. Results: High CIP2A immunoreactivity predicted poor survival in tongue cancer patients (P=0.027, logrank test). In multivariate survival analysis, CIP2A was an independent prognostic factor (HR 2.02, 95% confidence interval 1.07–3.82, P=0.030). Cytoplasmic CIP2A expression was higher in severe dysplasia than in mild dysplasia. Conclusion: Our results suggest that high CIP2A expression characterises aggressive disease. Acting as a prognostic marker it might be of help when choosing patients for adjuvant treatment in tongue cancer patients.

Bockelman, C; Hagstrom, J; Makinen, L K; Keski-Santti, H; Hayry, V; Lundin, J; Atula, T; Ristimaki, A; Haglund, C



Prognostic Index for Portal Vein Tumor Thrombosis in Patients with Hepatocellular Carcinoma Treated with Radiation Therapy  

PubMed Central

We performed a retrospective review of 281 hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) treated with radiation therapy (RT) between 1998 and 2008 to develop a prognostic model for those patients. Of the 281 patients, PVTT and intrahepatic main masses completely disappeared in 10 patients (3.6%), and shown a partial response in 141 patients (50.2%). The median survival was 11.6 months. Patients who had more than PR have shown significantly longer survival than the others (22.0 months vs 5.0 months, P < 0.001). On the multivariate analysis, pre-treatment poor prognosticators for overall survival were ECOG performance status, Child-Pugh class, multiple tumors, main PVTT, complete portal vein occlusion, lymph node metastasis, and primary tumor size. Prognostic index of RT for PVTT of HCC (PITH) scores were defined as the number of pre-treatment poor prognostic factors. PITH scores correlated well with overall survival. In the analysis of 1 and 2 yr overall survival rate, patients who had PITH scores of 3 or greater showed a significantly lower rate of overall survival than the others (33.0%, 17.3% vs 70.1%, 40.8%, respectively, P < 0.001). The PITH scoring model, proposed in the current study in HCC patients with PVTT, reliably predict overall survival.

Yu, Jeong Il; Lim, Do Hoon; Park, Won; Yoo, Byung Chul; Paik, Seung Woon; Koh, Kwang Cheol; Lee, Joon Hyuk



Prognostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography in Patients with Resectable Pancreatic Cancer  

PubMed Central

Purpose We evaluated the prognostic value of 18F-2-fluoro-2-deoxyglucose positron emission tomography (FDG PET) in patients with resectable pancreatic cancer. Materials and Methods We retrospectively reviewed the medical records of pancreatic cancer patients who underwent curative resection, which included 64 consecutive patients who had preoperative FDG PET scans. For statistical analysis, the maximal standardized uptake value (SUVmax) of primary pancreatic cancer was measured. Survival time was estimated by the Kaplan-Meier method, and Cox's proportional hazard model was used to determine whether SUVmax added new predictive information concerning survival together with known prognostic factors. p<0.05 indicated statistical significance. Results Overall survival (OS) and disease-free survival (DFS) were respectively 42.9 months (27.6-58.2; 95% CI) and 14.9 months (10.1-19.7; 95% CI). When subjects were divided into two groups according to SUVmax with a cutoff value of 3.5, the high SUVmax group (n=32; SUVmax >3.5) showed significantly shorter OS and DFS than the low SUVmax group. Multivariate analysis of OS and DFS showed that both high SUVmax and poor tumor differentiation were independent poor prognostic factors. Conclusion Our study showed that degree of FDG uptake was an independent prognostic factor in pancreatic cancer patients who underwent curative resection.

Choi, Hye Jin; Kang, Chang Moo; Lee, Woo Jung; Song, Si Young; Cho, Arthur; Yun, Mijin; Lee, Jong Doo; Kim, Joo Hang



The prevalence of poor reading in Dutch special elementary education.  


The relative frequency of poor readers in Dutch general elementary education (GEE) and special elementary education (SEE) and the characteristics of their reading performance were investigated using a lexical decision procedure. According to the same norms that identified 9% of students as poor readers in GEE, no less than 73% of the students in SEE were classified as poor readers. On average, the GEE poor readers were better readers than those in SEE, but the findings do not point to substantial differences in reading processes between the two reader groups. Hypotheses about the nature of the referral process that may cause this surprisingly strong relation between poor reading ability and SEE placement are advanced. PMID:17165616

van Bon, Wim H J; Bouwmans, Mieke; Broeders, Ivy N L D C


Are poor Chinese text comprehenders also poor in written composition?  


We studied the performance in three genres of Chinese written composition (narration, exposition, and argumentation) of 158 grade 4, 5, and 6 poor Chinese text comprehenders compared with 156 good Chinese text comprehenders. We examined text comprehension and written composition relationship. Verbal working memory (verbal span working memory and operation span working memory) and different levels of linguistic tasks-morphological sensitivity (morphological compounding and morphological chain), sentence processing (syntax construction and syntax integrity), and text comprehension (narrative and expository texts)-were used to predict separately narrative, expository, and argumentation written compositions in these students. Grade for grade, the good text comprehenders outperformed the poor text comprehenders in all tasks, except for morphological chain. Hierarchical multiple regression analyses showed differential contribution of the tasks to different genres of writing. In particular, text comprehension made unique contribution to argumentation writing in the poor text comprehenders. Future studies should ask students to read and write parallel passages in the same genre for better comparison and incorporate both instructional and motivational variables. PMID:23666849

Guan, Connie Qun; Ye, Feifei; Meng, Wanjin; Leong, Che Kan



Idiopathic pulmonary fibrosis: diagnosis and prognostic evaluation.  


Idiopathic pulmonary fibrosis (IPF) is the most common type of idiopathic interstitial pneumonia and has a dismal prognosis. Median age at IPF onset is 60-70 years and it is mainly related to cigarette smoke exposure. Its clinical profile is heterogeneous and different clinical phenotypes are now better defined: familial IPF, slow and rapid progressors, combined pulmonary fibrosis and emphysema, anti-neutrophil cytoplasmic antibodies/microscopic polyangiitis and IPF, and IPF associated with lung cancer. Acute exacerbation associated with rapid functional decline is an event that does not happen infrequently and affects survival. Diagnosis requires a typical usual interstitial pneumonia (UIP) pattern on computed tomography in the appropriate clinical setting or morphological confirmation of the UIP pattern when imaging findings are not characteristic enough. Surgical lung biopsy is the gold standard to obtain valuable information for histological analysis. However, less invasive procedures (transbronchial lung biopsy or even improved transbronchial lung biopsy by cryoprobes) are now under consideration. Prognostic indicators are mainly derived by pulmonary function tests. Recently, staging systems have been proposed. PMID:23816667

Poletti, Venerino; Ravaglia, Claudia; Buccioli, Matteo; Tantalocco, Paola; Piciucchi, Sara; Dubini, Alessandra; Carloni, Angelo; Chilosi, Marco; Tomassetti, Sara



Posttreatment cut-off levels of squamous cell carcinoma antigen as a prognostic factor in patients with locally advanced cervical cancer treated with radiotherapy  

PubMed Central

Objective The aim of the present study was to assess prognostic factors for patients with locally advanced cervical cancer treated with radiotherapy as the primary treatment and to assess the posttreatment cut-off levels of squamous cell carcinoma antigen (SCC-Ag) to predict three-year overall survival (OS) rates. Methods One hundred and twenty-eight patients with cervical squamous cell carcinoma (International Federation of Gynecology and Obstetrics [FIGO] stage IIB-IVA) treated using radiotherapy or concurrent chemoradiotherapy were identified. Of these patients, 116 who had SCC-Ag levels >1.5 ng/mL prior to treatment were analyzed retrospectively. Results Median age was 68 years (range, 27 to 79 years). The complete response rate was 70.7% and the three-year OS rate was 61.1%. The median levels of pretreatment and posttreatment SCC-Ag were 11.5 ng/mL (range, 1.6 to 310.0 ng/mL) and 0.9 ng/mL (range, 0.4 to 41.0 ng/mL), respectively. Multivariate analysis showed that pretreatment anemia (p=0.041), pelvic lymph node metastasis (p=0.016) and posttreatment SCC-Ag levels (p=0.001) were independent prognostic factors for three-year OS. The SCC-Ag level cut-off point for three-year OS rates, calculated using a receiver operating characteristic curve, was 1.15 ng/mL (sensitivity, 80.0%; specificity, 74.0%). Conclusion Pretreatment anemia and pelvic lymph node metastasis are poor prognostic factors in locally advanced cervical cancer. Furthermore, posttreatment SCC-Ag levels <1.15 ng/mL predicted better three-year OS rates.

Furukawa, Naoto; Kobayashi, Hiroshi; Asakawa, Isao



The Poor Cartographer: Graph Coloring  

NSDL National Science Digital Library

In this activity, learners help a poor cartographer color in the countries on a map, making sure each country is colored a different color than any of its neighbors. Through this exercise, learners discover the "has-to-be" rule and the value of place-holders. This activity reveals the complexity of graph coloring algorithms in computer science. Variations, extensions, background information, and solutions are included in the PDF.

Bell, Tim; Witten, Ian; Fellows, Mike



The Question of the Poor  

Microsoft Academic Search

\\u000a Rejecting the neutral, managerial, donor-driven, and client-oriented developmentalism of the “third sector,” this chapter\\u000a argues for reinventing the meaning and location of the third sector as a normatively and theoretically new paradigm that is\\u000a anchored in the emancipatory political project of transforming dominant structures of power, protecting human rights, and\\u000a increasing the sphere of democratic life for the poor. Based

Ashwani Kumar


Measuring Pro-Poor Growth  

Microsoft Academic Search

August 2001New tools allow one to study the incidence of economic growth by initial leveof income, and to measure the rate of pro-poor growth in an economy. An application is provided using data for China in the 1990s.It is important to know how aggregate economic growth or contraction was distributed according to initial levels of living. In particular, to what

Martin Ravallion; Shaohua Chen



LMP1 and LMP2A are potential prognostic markers of extranodal NK/T-cell lymphoma, nasal type (ENKTL)  

PubMed Central

Background Latent membrane protein (LMP) 1 and LMP2A encoded by Epstein-Barr virus (EBV) are associated with the development of malignancies, but their expression in extranodal NK/T-cell lymphoma, nasal type (ENKTL) and the relationship with clinical characteristics of this disease remain poorly understood. In the present study, we examined the expression of LMP1 and LMP2A in ENKTL, and investigated the correlations between LMP1 and LMP2A expression with clinicopathological characteristics of ENKTL patients. Methods Paraffin sections of surgically removed samples from 16 ENKTL patients were analyzed by immunohistochemistry and the related clinicopathological data were collected and analyzed. Results Elevated expression (immunohistochemistry score???4) of LMP1 and LMP2A was detected in the tumor cells of ENKTL. High LMP1 expression was associated with positive B symptoms (p?=?0.012), while high LMP2A expression was related to gender (p?=?0.029). The expression of both LMP1 and LMP2A showed significant correlations with patients’ overall survival (p?=?0.049, p?=?0.036). Conclusion LMP1 and LMP2A may be prognostic indicators of survival in patients with ENKTL. Virtual slides



Genotoxicity of poorly soluble particles.  


Poorly soluble particles such as TiO2, carbon black, and diesel exhaust particles have been evaluated for their genotoxicity using both in vitro and in vivo assays, since inhalation of these compounds by rats at high concentrations has been found to lead to tumor formation. Two principle modes of genotoxic action can be considered for particles, referred to as primary and secondary genotoxicity. Primary genotoxicity is defined as genetic damage elicited by particles in the absence of pulmonary inflammation, whereas secondary genotoxicity implies a pathway of genetic damage resulting from the oxidative DNA attack by reactive oxygen/nitrogen species (ROS/RNS), generated during particle-elicited inflammation. Conceptually, primary genotoxicity might operate via various mechanisms, such as the actions of ROS (e.g., as generated from reactive particle surfaces), or DNA-adduct formation by reactive metabolites of particle-associated organic compounds (e.g., polycyclic aromatic hydrocarbons). Currently available literature data, however, merely indicate that the tumorigenesis of poorly soluble particles involves a mechanism of secondary genotoxicity. However, further research is urgently required, since (1) causality between pulmonary inflammation and genotoxicity has not yet been established, and (2) effects of inflammation on fundamental DNA damage responses that orchestrate mutagenesis and carcinogenic outcome,that is, cell cycle arrest, DNA repair, proliferation, and apoptosis, are currently poorly understood. PMID:17886067

Schins, Roel P F; Knaapen, Ad M



Designing prognostic models by reinforcing linear separation.  


Variety of prognostic models can be designed on the basis of learning sets by using the principle of linear separability. The degree of linear separability of two learning sets can be evaluated on the basis of the minimal value of the perceptron criterion function, which belongs to a larger family of the convex and piecewise linear (CPL) criterion functions. Parameters constituting the minimal value of a given CPL criterion function can define particular prognostic model. Prognostic models have been designed this way, for example, on the basis of genetic data sets. PMID:23542963

Bobrowski, Leon



Clinical Correlates and Prognostic Significance of the Ventilatory Response to Exercise in Chronic Heart Failure  

Microsoft Academic Search

Objectives. This study sought to investigate the clinical characteristics of patients with chronic heart failure and an increased ventilatory response to exercise and to examine the prognostic usefulness of this response.Background. The ventilatory response to exercise is increased in many patients with chronic heart failure and may be characterized by the regression slope relating minute ventilation to carbon dioxide output

Tuan Peng Chua; Piotr Ponikowski; Derek Harrington; Stefan D Anker; Katharine Webb-Peploe; Andrew L Clark; Philip A Poole-Wilson; Andrew J. S Coats



Prevalence and prognostic significance of exercise-induced supraventricular tachycardia in apparently healthy volunteers  

Microsoft Academic Search

The prevalence, characteristics, and prognostic significance of supraventricular tachycardia (SVT) occurring during maximal treadmill exercise testing were examined in 843 male and 540 female asymptomatic volunteers aged 20 to 94 years from the Baltimore Longitudinal Study of Aging who underwent exercise testing a mean or 2.3 times between 1977 and 1991. Exercise-induced SVT occurred during at least 1 test in

Mathew S. Maurer; Elliot A. Shefrin; Jerome L. Fleg



FDG–PET. A possible prognostic factor in head and neck cancer  

Microsoft Academic Search

Previous studies have shown that high uptake of 18F-fluoro-2-deoxy-glucose in head and neck cancer, as determined by the standardized uptake value on positron emission tomography scan, was associated with poor survival. The aim of this study was to confirm the association and to establish whether a high standardized uptake value had prognostic significance. Seventy-three consecutive patients with newly diagnosed squamous

W Halfpenny; S F Hain; L Biassoni; M N Maisey; J A Sherman; M McGurk



Tissue biomarkers as prognostic variables of cervical cancer.  


The most important prognostic variables of cervical carcinoma are FIGO stage, lymph node status and clinical-pathological features of primary tumor. Recently, there has been increasing interest in the identification of biomarkers able to predict both response to treatment and survival. The aim of this review is to critically evaluate current published evidence on the ability of various tissue biomarkers to predict the clinical outcome of patients with cervical carcinoma. In particular, the paper takes into account DNA content, cell-cycle and apoptosis-regulatory proteins, epidermal growth factor receptor [EGFR], vascular endothelial growth factor [VEGF], cyclooxygenase [COX]-2, signal transducer and activator of transcription [Stat]3, human papilloma virus [HPV] status, tumor hypoxia, tumor infiltrating lymphocytes [TIL], microarray technology and microRNA (miRNA). The presence of HPV-18 genotype and an elevated VEGF expression appear to be poor prognostic factors in women with early disease treated with primary surgery, whereas the expression of EGFR, VEGF, COX-2 and tumor hypoxia may have a major impact on the survival of patients treated with definitive radiotherapy or chemoradiation. The data supporting the reliability of ?Np73 and TAp73? as novel biomarkers of response to radiotherapy are interesting but still limited. DNA microarray technology could offer new laboratory tools for a rationale planning of treatment strategy, and miRNAs might represent new candidate targets to be investigated for both prognostic and therapeutic purposes. Moreover, the assessment of different types of TIL and their ligands in tumor biopsies could enable the identification of a subset of high-risk patients, paving the way to novel immune therapies aimed at blocking T-reg cell activity. PMID:23031678

Gadducci, Angiolo; Guerrieri, Maria Elena; Greco, Carlo



Course, risk factors, and prognostic factors in elderly primary care patients with mild depression: A two-year observational study  

PubMed Central

Abstract Objective. The aim of this study was to observe course, risk factors, and prognostic factors in a primary care cohort aged > 60 with mild to moderate depression during two-year follow-up. Design. Observational study. Setting. Primary care. Subjects and method. During an 11-month period all (n = 302) consecutive patients aged 60 and above attending a primary care centre in Gothenburg, Sweden were screened by a nurse for depressive symptoms with the Primary Care Evaluation of Mental Disorders, Patient Questionnaire (PRIME-MD PQ) and the Montgomery-Åsberg Depression Rating Scale, self-rated version (MADRS-S) and by a GP with a patient-centred consultation model. In the second step, the GPs diagnosed depression in screen-positives by use of the PRIME-MD Clinical Evaluation Guide (PRIME-MD CEG). All patients with mild to moderate depression were followed up for two years to assess course with several MADRS-S score assessments. Main outcome measures. Risk factors, prognostic factors, and symptoms at baseline and after two years were tested with logistic regression, using the DSM-IV and MADRS-S (cut-off > 13) respectively. Course patterns were observed and described. Results. A total of 54 patients were diagnosed with depression. Follow-up revealed declining median MADRS-S scores and three course patterns: remitting, stable, and fluctuating. History of depression, significant life events, lacking leisure activities, and use of sedatives were risk factors for depression, all previously known. An important finding was that lacking leisure activities also increased the risk of depressive symptoms after two years (odds ratio 12, confidence interval 1.1–136). Conclusion. It is desirable to identify elderly individuals with less severe depression. Three course patterns were observed; this finding requires further study of the clinical characteristics related to the different patterns. Awareness of risk factors may facilitate identification of those at highest risk of poor prognosis.



Serum peptidomic profiling identifies a minimal residual disease detection and prognostic biomarker for patients with acute leukemia  

PubMed Central

The evaluation of minimal residual disease (MRD) in acute leukemia (AL) is currently recognized as a potential critical tool to assess the response and relapse rate of treatments. The present study investigated serum peptides from patients with AL to identify biomarkers that would be useful in providing clinical evaluations and independent prognostic information. The patterns of serum peptides from 123 patients with AL and 49 healthy controls were analyzed using matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Furthermore, diagnostic models of differential peptides were established using the support vector machine (SVM) algorithm to discriminate between the AL patients and healthy controls or between the AL patients with various degrees of remission. Finally, the peptides were applied to evaluate the prognosis of the affected patients. The area under the receiver operating characteristic (ROC) curve (AUC), analyzed using the SVM algorithm to distinguish between the AL patients and healthy controls, was 0.921. The AUC of the models for distinguishing between the newly-diagnosed AL patients and those in AL-hematological complete remission (HCR) and between the AL-HCR patients from those in AL-molecular remission (MR), was 0.824 and 0.919, respectively. A short serum peptide of m/z 4625 was identified to decrease in density in parallel with an increase in the degree of remission, which was used to monitor the MRD level. The intensity of the m/z 4625 peptide was significantly correlated with a poor overall survival (OS). The m/z 4625 peptide was identified to be a partial fragment of SERPINA3. The serum peptide pattern is high in sensitivity and specificity and may be used to discriminate between AL patients with various degrees of remission. The m/z 4625 peptide may be used to monitor the MRD levels and provide independent prognostic information in patients with AL.




Comparison of Prognostic Genomic Predictors in Colorectal Cancer  

PubMed Central

Background Although several prognostic genomic predictors have been identified from independent studies, it remains unclear whether these predictors are actually concordant with respect to their predictions for individual patients and which predictor performs best. We compared five prognostic genomic predictors, the V7RHS, the ColoGuideEx, the Meta163, the OncoDX, and the MDA114, in terms of predicting disease-free survival in two independent cohorts of patients with colorectal cancer. Study Design Using original classification algorithms, we tested the predictions of five genomic predictors for disease-free survival in two cohorts of patients with colorectal cancer (n?=?229 and n?=?168) and evaluated concordance of predictors in predicting outcomes for individual patients. Results We found that only two predictors, OncoDX and MDA114, demonstrated robust performance in identifying patients with poor prognosis in 2 independent cohorts. These two predictors also had modest but significant concordance of predicted outcome (r>0.3, P<0.001 in both cohorts). Conclusions Further validation of developed genomic predictors is necessary. Despite the limited number of genes shared by OncoDX and MDA114, individual-patient outcomes predicted by these two predictors were significantly concordant.

Kim, Sang Cheol; Kim, Sang Bae; Sohn, Bo Hwa; Chu, In-Sun; Oh, Sang Cheul; Park, Eun Sung; Jeong, Woojin; Kim, Sung Soo; Kopetz, Scott; Lee, Ju-Seog



Accelerated Aging in Electrolytic Capacitors for Prognostics.  

National Technical Information Service (NTIS)

The focus of this work is the analysis of different degradation phenomena based on thermal overstress and electrical overstress accelerated aging systems and the use of accelerated aging techniques for prognostics algorithm development. Results on thermal...

C. Kulkarni G. Biswas J. R. Celaya K. F. Goebel S. Saha



Prognostic Significance of DNA and Histone Methylation

Nutritional Science Research Group Recently Funded Projects Prognostic Significance of DNA and Histone Methylation Principal Investigator: Piyathilake, Chandrika J Institution: University of Alabama at Birmingham   NCI/DCP Program Director: Ross, Sharon


Relationship between Uric Acid Levels and Diagnostic and Prognostic Outcomes in Acute Heart Failure  

PubMed Central

Objectives We evaluated the association of plasma uric acid alone and in combination with b-type natriuretic peptide (BNP) for emergency department (ED) diagnosis and 30-day prognosis in patients evaluated for acute heart failure (AHF). Methods We prospectively enrolled 322 adult ED patients with suspected AHF. Wilcoxon rank sum test, multivariable logistic regression and likelihood ratio (LR) tests were used for statistical analyses. Results Uric acid’s diagnostic utility was poor and failed to show significant associations with 30-day clinical outcomes. Uric acid also did not add significantly to BNP results. Conclusion Among ED patients with suspected AHF, uric acid has poor diagnostic and prognostic utility.

Henry-Okafor, Queen; Collins, Sean P.; Jenkins, Cathy A.; Miller, Karen F.; Maron, David J.; Naftilan, Allen J.; Weintraub, Neal; Fermann, Gregory J.; McPherson, John; Menon, Santosh; Sawyer, Douglas B.; Storrow, Alan B.



Prognostic factors after cryotherapy for hepatic metastases from colorectal cancer.  

PubMed Central

OBJECTIVE: To establish the prognostic importance of different patient and tumor characteristics in cryotherapy for liver metastases from colorectal cancer. SUMMARY BACKGROUND DATA: Hepatic cryotherapy has been used as a treatment of nonresectable liver metastases from colorectal cancer in almost 1000 patients worldwide, and its safety and efficacy are well established. However, tumor eventually recurs in most patients and they die of their disease. The knowledge of prognostic factors would allow the selection of patients who are more likely to benefit from this treatment and patients who may need additional treatment. METHODS: Between April 1990 and May 1997, 195 patients were treated with hepatic cryotherapy. Out of this group, the authors identified 116 patients with colorectal cancer who received cryotherapy for ablation of liver metastases. Survival was estimated with the Kaplan-Meier method, using the log-rank test for univariate analysis for significance of possible prognostic factors. For multivariate analysis, a Cox regression was used. RESULTS: One patient (0.9%) died of postoperative myocardial infarction. The total perioperative morbidity rate was 27.6%. Median survival and the 5-year survival rate were 26 months and 13.4%. The following factors were identified as independently associated with a favorable outcome: low presurgical serum level of carcinoembryonic antigen (CEA), small (< or =3 cm) diameter of cryoablated metastases, absence of untreated extrahepatic disease at laparotomy, absence of nodal involvement at primary resection, complete cryotreatment, synchronous development of liver metastases, and good or moderate differentiation of the primary tumor. Although univariate analysis suggested a favorable prognosis in patients who did not receive blood transfusion during surgery and patients younger than 51 years, this was not confirmed in multivariate analysis. In addition, normalization of the serum CEA level after treatment was an important prognostic marker in the subgroup of patients with elevated serum CEA levels before surgery. CONCLUSIONS: Hepatic cryotherapy is a safe and effective treatment option for patients with nonresectable liver metastases from colorectal cancer, with promising results regarding survival. The prognostic factors established in this series may allow better patient selection to improve the outcome in suitable patients.

Seifert, J K; Morris, D L



The Glasgow Prognostic Score (GPS) as a novel and significant predictor of extranodal natural killer/T-cell lymphoma, nasal type.  


The Glasgow Prognostic Score (GPS), an inflammation-based prognostic score including C-reactive protein and albumin, shows significant prognostic value in several types of solid tumors. The prognostic value of GPS in lymphoma remains unclear. We performed this study to evaluate the prognostic significance of GPS in extranodal natural killer (NK)/T-cell lymphoma (ENKL). We retrospectively analyzed 164 patients with newly diagnosed ENKL. The prognostic value of GPS was evaluated and compared with that of International Prognostic Index (IPI), Prognostic Index for Peripheral T-cell lymphoma unspecified (PIT), and Korean Prognostic Index (KPI). Patients with higher GPS tended to have more adverse clinical characteristics, lower rates of complete remission (P < 0.001), inferior progression-free survival (PFS, P < 0.001), and inferior overall survival (OS, P < 0.001). Multivariate analysis demonstrated that high GPS, age > 60 years, and elevated LDH were independent adverse predictors of OS. GPS was found superior to IPI, PIT, and KPI in discriminating patients with different outcomes in low-risk groups (all P < 0.05). GPS is an independent predictor of survival outcomes in ENKL. Inflammatory response might play an important role in the progression of ENKL and survival of patients with ENKL. PMID:23423859

Li, Ya-Jun; Jiang, Wen-Qi; Huang, Jia-Jia; Xia, Zhong-Jun; Huang, Hui-Qiang; Li, Zhi-Ming



Prognostic factors and risk stratification in early mycosis fungoides.  


Available demographic, clinical, histologic, immunohistochemical and laboratory findings, including serum cytokine/cytokine receptor levels, obtained at initial evaluation in a cohort of 33 patients with mycosis fungoides (MF) at stages I-IIA who had subsequent progression of disease were compared against 70 stage-matched cases of MF without observed progression. Significant factors that correlated with both disease progression and overall survival were: (1) presence of large Pautrier microabscesses (10 or more atypical lymphocytes), (2) presence of atypical lymphocytes with hyperchromatic or vesicular nuclei in the dermal infiltrate, (3) less than 20% CD8 + cells in the dermal infiltrate and (4) above normal (> 122 U/mL) serum immunoglobulin E (IgE) level. Combination of these factors was used to construct prognostic groupings which, if validated, might be useful to identify patients with clinically early MF at highest risk for disease progression and poor outcome. PMID:23547839

Vonderheid, Eric C; Pavlov, Igor; Delgado, Julio C; Martins, Thomas B; Telang, Gladys H; Hess, Allan D; Kadin, Marshall E



Critical illness neuromuscular disease: clinical, electrophysiological, and prognostic aspects  

PubMed Central

Background: Critical illness neuromuscular disease, which has been recognised as a distinct clinical entity in adults, remains poorly described in children. Aims: To assess retrospectively the clinical, electrophysiological, and prognostic features of the disease. Methods: Retrospective study in a children's university hospital. Results: Five critically ill patients presented with generalised paralysis, associated with long lasting failure to breathe in three. The cause of the generalised paralysis was critical illness neuropathy in two, acute myopathy in two, and mixed neuromyopathy in one. Conclusions: Neuromuscular disease should be suspected in critically ill children with muscle weakness. Because corticosteroids and muscle relaxants appear to trigger some types of intensive care unit neuromuscular disease in children, their use should be restricted or administered at the lowest doses possible.

Tabarki, B; Coffinieres, A; Van den Bergh, P; Huault, G; Landrieu, P; Sebire, G



Serum C-Reactive Protein (CRP) as a Simple and Independent Prognostic Factor in Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type  

PubMed Central

Background C-reactive protein (CRP) is a biomarker of the inflammatory response, and it shows significant prognostic value for several types of solid tumors. The prognostic significance of CRP for lymphoma has not been fully examined. We evaluated the prognostic role of baseline serum CRP levels in patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTL). Methods We retrospectively analyzed 185 patients with newly diagnosed ENKTL. The prognostic value of the serum CRP level was evaluated for the low-CRP group (CRP?10 mg/L) versus the high-CRP group (CRP>10 mg/L). The prognostic value of the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI) were evaluated and compared with the newly developed prognostic model. Results Patients in the high-CRP group tended to display increased adverse clinical characteristics, lower rates of complete remission (P<0.001), inferior progression-free survival (PFS, P?=?0.001), and inferior overall survival (OS, P<0.001). Multivariate analysis demonstrated that elevated serum CRP levels, age >60 years, hypoalbuminemia, and elevated lactate dehydrogenase levels were independent adverse predictors of OS. Based on these four independent predictors, we constructed a new prognostic model that identified 4 groups with varying OS: group 1, no adverse factors; group 2, 1 factor; group 3, 2 factors; and group 4, 3 or 4 factors (P<0.001). The novel prognostic model was found to be superior to both the IPI in discriminating patients with different outcomes in the IPI low-risk group and the KPI in distinguishing between the low- and intermediate-low-risk groups, the intermediate-low- and high-intermediate-risk groups, and the high-intermediate- and high-risk groups. Conclusions Our results suggest that pretreatment serum CRP levels represent an independent predictor of clinical outcome for patients with ENKTL. The prognostic value of the new prognostic model is superior to both IPI and KPI.

Xia, Yi; Huang, Jia-Jia; Huang, Hui-Qiang; Xia, Zhong-Jun; Lin, Tong-Yu; Li, Su; Cai, Xiu-Yu; Wu-Xiao, Zhi-Jun; Jiang, Wen-Qi



A prognostic rule for elderly patients admitted with community-acquired pneumonia  

Microsoft Academic Search

PURPOSE: We sought to identify admission characteristics predicting mortality in elderly patients hospitalized with community-acquired pneumonia and to develop a prognostic staging system and discriminant rule.PATIENTS AND METHODS: We retrospectively analyzed data from 2,356 patients aged ?65 years admitted with community-acquired pneumonia. Multivariable analyses of a derivation cohort (n = 1,000) identified characteristics associated with hospital mortality. A staging system

Harry A Conte; Ya-Ting Chen; Wajahat Mehal; D Phil; Jeanne D Scinto; Vincent J Quagliarello



Brain metastases from hepatocellular carcinoma: clinical features and prognostic factors  

PubMed Central

Background Brain metastases (BM) from hepatocellular carcinoma (HCC) are extremely rare and are associated with a poor prognosis. The aim of this study was to define clinical outcome and prognostic determinants in patients with BM from HCC. Methods Between January 1994 and December 2009, all patients with HCC and BM treated in Sun Yat-sen University Cancer Center were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possible prognostic factors. Results Forty-one patients were diagnosed with BM from HCC, an incidence of 0.47%. The median age at diagnosis of BM was 48.5 years. Thirty-three patients (80.5%) developed extracranial metastases at diagnosis of BM, and 30 patients (73.2%) had hepatitis B. Intracranial hemorrhage occurred in 19 patients (46.3%). BM were treated primarily either with whole brain radiation therapy (WBRT; 5 patients), stereotactic radiosurgery (SRS; 7 patients), or surgical resection (6 patients). The cause of death was systemic disease in 17 patients and neurological disease in 23. Patients in a high RPA (recursive partitioning analysis) class, treated with conservatively and without lung metastases, tended to die from neurological disease. Median survival after the diagnosis of BM was 3 months (95% confidence interval: 2.2-3.8 months). In multivariate analysis, the presence of extracranial metastases, a low RPA class and aggressive treatment, were positively associated with improved survival. Conclusions BM from HCC is rare and associated with an extremely poor prognosis. However, patients with a low RPA class may benefit from aggressive treatment. The clinical implication of extracranial metastases in HCC patients with BM needs further assessment.



MiR-27 as a Prognostic Marker for Breast Cancer Progression and Patient Survival  

PubMed Central

Background MicroRNA-27a (miR-27a) is thought to be an onco-microRNA that promotes tumor growth and metastasis by downregulating ZBTB10. The potential predictive value of miR-27a was studied in breast cancer patients. Methods The expression of miR-27a and ZBTB10 was examined in 102 breast cancer cases using in situ hybridization (ISH) and immunohistochemistry techniques and were evaluated semi-quantitatively by examining the staining index. The Correlation of miR-27a and ZBTB10 expression was analyed by Spearman Rank Correlation. The association of miR-27a and ZBTB10 expression with clinicopathological characteristics was analyzed using the ?2 test, and their effects on patient survival were analyzed by a log-rank test and the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to evaluate the prognostic values of miR-27a and ZBTB10. Results miR-27a was markedly up-regulated in invasive breast cancers that expressed low levels of ZBTB10 (P<0.001). A reverse correlation between miR-27a and ZBTB10 was also observed in breast cancer tissue samples (rs?=??0.478, P<0.001). Furthermore, the expression of miR-27a and ZBTB10 was significantly correlated with clinicopathological parameters, including tumor size, lymph node metastasis and distant metastasis (P<0.05), but not with receptor status. Patients with high miR-27a or low ZBTB10 expression tended to have significantly shorter disease-free survival times (57 months and 53 months, respectively, P <0.001) and overall survival times (58 months and 55 months, respectively, P <0.001). Univariate and multivariate analysis showed that both miR-27a and ZBTB10 were independent prognostic factors of disease-free survival in breast cancer patients (P <0.001), while only miR-27a was an independent predictor of overall survival (P <0.001). Conclusions High miR-27a expression is associated with poor overall survival in patients with breast cancer, which suggests that miR-27a could be a valuable marker of breast cancer progression.

Su, Shicheng; Wu, Wei; Liu, Qiang; Su, Fengxi; Yu, Fengyan



Prognostic impact of CD10 expression in clinical outcome of invasive breast carcinoma.  


BACKGROUND: Early diagnosis and treatment for breast cancers has greatly improved in recent years, however, subset of this disease with early recurrence have remained to be unpredictable. Several studies has addressed that strong CD10 expression in tumor stroma is associated with poor survival rate of breast cancers, but no correlation between CD10 expression and disease-free survival has been elucidated yet. For these reasons, this study with modified immunohistochemical (IHC) staining evaluated the expression of CD10 in invasive breast carcinomas (IBCs) and analyzed correlations between CD10 expression on tumor cells, stromal cells and myeloid-like cells with clinicopathological parameters and recurrence status. METHOD: IHC staining method was performed on formalin-fixed paraffin-embedded sections of 73 cases of primary IBCs, with record of pathological characteristics of subjects followed up from 1998 to 2007. RESULTS: Stromal CD10 expression was observed in 39/73 cases (53.4 %) with strong expression in 41.0 %. Three cases stained positive for myeloid-like cells and five for carcinomatous cells, of which 6 cases had recurrence and/or regional LN status. Stromal CD10 expression was significantly higher in the unfavorable group (69.6 %; 16/23 cases) compared with the favorable group (32.1 %; 9/28 cases) (p = 0.048). The levels of CD10 expression showed significant difference among clinical outcomes (recurrence or non-recurrence), independent of regional LN status (p = 0.034), histology type (p = 0.044), ER status (p = 0.042), PgR status (p = 0.039), Her2 status (p = 0.038) and Ki67 index (p = 0.036) (partial Pearson correlations). Cox proportional-hazards regression showed that risk factors for disease-free survival were stromal CD10 expression [CD10±, CD10+ versus CD10++; p = 0.003; HR 2.824 (1.427-5.591)]; regional LN status [N0, N1, N2, versus N3; p = 0.004; HR 2.107 (1.262-3.517)] and PgR status [negative versus positive, p = 0.006, HR 0.172 (0.049-0.596)]. CONCLUSION: CD10 expression on stroma with or without other positive tumor cells and/or myeloid-like cells may function as a powerful prognostic factor for IBC disease-free survival rates, predicting of potential recurrence. It can be determined by a simple modified IHC staining method, which is independent of other prognostic morphologic markers and biomarkers in IBC. PMID:23575921

Vo, Thi-Ngoc Diem; Mekata, Eiji; Umeda, Tomoko; Abe, Hajime; Kawai, Yuki; Mori, Tsuyoshi; Kubota, Yoshihiro; Shiomi, Hisanori; Naka, Shigeyuki; Shimizu, Tomoharu; Murata, Satoshi; Yamamoto, Hiroshi; Ishida, Mitsuaki; Tani, Tohru



Hydrochemical case study of the poorly productive Irish bedrock aquifer  

Microsoft Academic Search

Poorly productive bedrock aquifers (PPBA) are characteristic of low porosity and small specific well yield. Not even they underlay a considerable area of Ireland (up to 70%) and worldwide, the heterogeneity of these low porosity aquifers with fractured dominated groundwater flow regime makes it increasingly important to comprehend the conceptual model of flow in such systems in order for further

Katarina Pilatova; Ulrcih Ofterdinger



Poor Facial Affect Recognition among Boys with Duchenne Muscular Dystrophy  

ERIC Educational Resources Information Center

|Children with Duchenne or Becker muscular dystrophy (MD) have delayed language and poor social skills and some meet criteria for Pervasive Developmental Disorder, yet they are identified by molecular, rather than behavioral, characteristics. To determine whether comprehension of facial affect is compromised in boys with MD, children were given a…

Hinton, V. J.; Fee, R. J.; De Vivo, D. C.; Goldstein, E.



In search of the poor  

Microsoft Academic Search

Economists tend to adopt an empiricist approach to poverty, commonly calculating it as the proportion of the population that fall below some specified income threshold. This approach has been developed to take into account heterogeneous household needs by using income equivalence scales, but most other individual characteristics are totally ignored. This paper questions the relevance of this approach by considering

Duncan Watson



A generic probabilistic framework for structural health prognostics and uncertainty management  

NASA Astrophysics Data System (ADS)

Structural health prognostics can be broadly applied to various engineered artifacts in an engineered system. However, techniques and methodologies for health prognostics become application-specific. This study thus aims at formulating a generic framework of structural health prognostics, which is composed of four core elements: (i) a generic health index system with synthesized health index (SHI), (ii) a generic offline learning scheme using the sparse Bayes learning (SBL) technique, (iii) a generic online prediction scheme using the similarity-based interpolation (SBI), and (iv) an uncertainty propagation map for the prognostic uncertainty management. The SHI enables the use of heterogeneous sensory signals; the sparseness feature employing only a few neighboring kernel functions enables the real-time prediction of remaining useful lives (RULs) regardless of data size; the SBI predicts the RULs with the background health knowledge obtained under uncertain manufacturing and operation conditions; and the uncertainty propagation map enables the predicted RULs to be loaded with their statistical characteristics. The proposed generic framework of structural health prognostics is thus applicable to different engineered systems and its effectiveness is demonstrated with two cases studies.

Wang, Pingfeng; Youn, Byeng D.; Hu, Chao



Serving the world's poor, profitably.  


By stimulating commerce and development at the bottom of the economic pyramid, multi-nationals could radically improve the lives of billions of people and help create a more stable, less dangerous world. Achieving this goal does not require MNCs to spearhead global social-development initiatives for charitable purposes. They need only act in their own self-interest. How? The authors lay out the business case for entering the world's poorest markets. Fully 65% of the world's population earns less than $2,000 per year--that's 4 billion people. But despite the vastness of this market, it remains largely untapped. The reluctance to invest is easy to understand, but it is, by and large, based on outdated assumptions of the developing world. While individual incomes may be low, the aggregate buying power of poor communities is actually quite large, representing a substantial market in many countries for what some might consider luxury goods like satellite television and phone services. Prices, and margins, are often much higher in poor neighborhoods than in their middle-class counterparts. And new technologies are already steadily reducing the effects of corruption, illiteracy, inadequate infrastructure, and other such barriers. Because these markets are in the earliest stages of economic development, revenue growth for multi-nationals entering them can be extremely rapid. MNCs can also lower costs, not only through low-cost labor but by transferring operating efficiencies and innovations developed to serve their existing operations. Certainly, succeeding in such markets requires MNCs to think creatively. The biggest change, though, has to come from executives: Unless business leaders confront their own preconceptions--particularly about the value of high-volume, low-margin businesses--companies are unlikely to master the challenges or reap the rewards of these developing markets. PMID:12227146

Prahalad, C K; Hammond, Allen



Decreased tumstatin-mRNA is associated with poor outcome in patients with NSCLC.  


Tumstatin is a candidate tumor suppressor that plays an important role in tumor growth and angiogenesis. The purpose of this study was to evaluate the correlation between tumstatin-mRNA expression and the clinicopathologic characteristics, tumor angiogenesis, outcome of patients with non-small cell lung cancer (NSCLC). Specimens from 68 patients with NSCLC were recruited in this study. Tumstatin-mRNA expression and protein level in tumor tissues were quantified respectively by quantitative RT-PCR and ELISA. Microvessel density (MVD) was determined by CD34 immunostaining. The correlation of tumstatin-mRNA expression levels with clinicopathologic variables, tumor angiogenesis, and prognosis was analyzed. Tumstatin-mRNA expression levels were decreased in tumor. Tumstatin-mRNA expression level was significantly correlated with its protein level in tumor (r = 0.562; P = 0.001). Tumstatin-mRNA expression levels in poorly differentiated tumor tissues were significantly lower than in well-differentiated tumor tissues (P < 0.004). Furthermore, tumor tumstatin-mRNA expression were also significantly related to tumor pathologic stage (P = 0.032) and MVD (r = -0.77, P < 0.0001). Overall survival (OS) and disease-free survival (DFS) analysis indicated that NSCLC patients with low tumstatin-mRNA expression had poorer OS and DFS than those with high expression (P = 0.015 and 0.037; respectively). Multivariable Cox regression analysis revealed that the tumstatin-mRNA expression could be an independent prognostic indicators in both DFS and OS. Tumstatin-mRNA expression levels are down-regulated in NSCLC tissues. Tumstatin-mRNA expression level correlates with prognosis, which suggests that tumstatin-mRNA is a new potential independent marker of favorable prognosis in NSCLC. PMID:22473740

Luo, Yi-Qin; Ming, Zhou; Zhao, Liang; Yao, Li-Juan; Dong, Hang; Du, Jian-Ping; Wu, Shuang-Zheng; Hu, Wen



Early-stage lung adenocarcinomas with a micropapillary pattern, a distinct pathologic marker for a significantly poor prognosis.  


Adenocarcinomas with a micropapillary pattern (MPP), featuring small papillary tufts lacking a central fibrovascular core, are thought to have a poor prognosis. To examine whether the MPP is a predictor of prognosis, clinicopathologic characteristics of adenocarcinomas were analyzed with particular reference to survival of early-stage patients. The subjects were 344 consecutive patients (female/male ratio 163:181) for whom complete surgical resection was undertaken at the Cancer Institute Hospital, Japan, during 1986-1995. Histologically, they were divided into two groups: MPP-positive (n = 139; 40%) and MPP-negative (n = 205; 60%). The following items were significantly more frequent in the MPP-positive group: metastasis to lymph nodes (p <0.001), pleural invasion (p = 0.02), intrapulmonary metastasis (p <0.001), and nonsmoking status (p = 0.002). In stage I patients (i.e., without lymph node metastasis, n = 154), 5-year survival of the MPP-positive group (n = 45) was 79%, significantly lower than the MPP-negative group (n = 109) of 93% (p = 0.004). In many cases of the c-stage I MPP-positive group, upstaging was necessary on the basis of pathologic findings for metastases, and the survival was between stage I and stage II. Our study clearly indicated that the MPP is a distinct prognostic marker for lung adenocarcinoma, particularly regarding apparent stage I diseases. PMID:12502932

Miyoshi, Tatsu; Satoh, Yukitoshi; Okumura, Sakae; Nakagawa, Ken; Shirakusa, Takayuki; Tsuchiya, Eiju; Ishikawa, Yuichi



Tumour growth rate and DNA flow cytometry parameters as prognostic factors in metastatic melanoma.  

PubMed Central

The prognostic value of flow cytometric parameters and tumour growth rate of melanoma metastases under the mouse renal capsule was investigated for tumours from 117 consecutive patients referred to the Helsinki University Central Hospital Melanoma Team. DNA flow cytometry (FCM) was interpretable for the tumours of 114 patients, and growth rate analysis for 82 patients, both results being available from 79 patients. Thirty-six percent of the tumours were DNA diploid and 64% DNA aneuploid. Tumour ploidy and S-phase fraction were shown by multivariate Cox model analysis to be independent prognostic variables and major determinants of survival after first recurrence. Patients with DNA diploid or aneuploid tumours survived a median 16 and 27 months, respectively. A high growth rate of tumour sample in vivo under the mouse renal capsule tended to be a sign of poor prognosis, although not reaching statistical significance. Combining the results of FCM, tumour growth rate and TNM stage, we propose a highly efficient prognostic scoring method. Patients with a score above 0.75 had a median survival of 11 months compared to 30 months among patients scoring under 0.75 (P less than 0.0001). This score was the most significant (P less than 0.0001) prognostic factor in the Cox model when TNM stage, age, ploidy, SPF, and tumour growth rate were analysed as covariates.

Muhonen, T.; Pyrhonen, S.; Laasonen, A.; Wasenius, V. M.; Asko-Seljavaara, S.; Franssila, K.; Kangas, L.



Is BPPV a Prognostic Factor in Idiopathic Sudden Sensory Hearing Loss?  

PubMed Central

Objectives The prognostic significance of vertigo in patients with idiopathic sudden sensorineural hearing loss (SSNHL) remains a matter of debate because vertigo is associated with many different vestibular disorders. The purpose of this study is to determine the role of benign paroxysmal positional vertigo (BPPV) as a prognostic factor in patients with SSNHL. Methods We conducted a retrospective study of 298 patients with SSNHL. Hearing outcomes were evaluated by assessments of pre-treatment hearing and hearing gain. Comparative multivariate analyses between prognostic factors and hearing outcome were conducted. Results Thirty-eight (12.7%) SSNHL patients were found to also have BPPV. BPPV showed significant negative prognostic factors in hearing outcome on multivariate analysis (odds ratio, 0.15). In comparison to average pure tone audiometry (PTA), patients diagnosed with SSNHL with BPPV exhibited poorer hearing in pre- and post-treatment PTA compared to SSNHL without BPPV. Old age (>60 years), pre-treatment hearing, and canal paresis were significant outcome predictors. Conclusion BPPV in SSNHL patients, representing definitive vestibular damage, was closely related to poor prognosis.

Lee, No Hee



Overexpression of p53 protein is an independent prognostic indicator in human endometrial carcinoma.  

PubMed Central

The important role of the p53 gene in tumour progression and cellular response to DNA damage has prompted investigation of the clinical significance of alterations to this gene. We examined both p53 overexpression and mutation of the gene in endometrial carcinoma in order to evaluate the prognostic significance of these changes. Of 122 endometrial carcinomas, 33 (27%) showed overexpression of p53 in the nucleus and 66 (54%) in the cytoplasm. Mutation in the p53 gene was found in 16 (13%) cases but showed no significant association with patient survival. Nuclear p53 overexpression was associated with poor survival (48% vs 80% alive in negative tumours 5 years post operatively, P < 0.001). In contrast, cytoplasmic p53 overexpression was associated with better survival (85% vs 55%, P < 0.001). When patients were separated into prognostic subgroups according to established clinical markers, these associations remained significant within most subgroups examined. In multivariate analysis adjusted for surgical stage, histological grade and type and vascular invasion, both nuclear p53 overexpression [hazard ratio 4.9 (95% CI 1.3-17.6). P = 0.016] and cytoplasmic overexpression [0.25 (0.06-0.98), P = 0.047] were independent prognostic factors. Immunohistochemical assessment of p53 overexpression in the nucleus and cytoplasm could provide useful prognostic information for the management of patients with endometrial cancer. Images Figure 1 Figure 2

Soong, R.; Knowles, S.; Williams, K. E.; Hammond, I. G.; Wysocki, S. J.; Iacopetta, B. J.



HER-2 Expression in Immunohistochemistry Has No Prognostic Significance in Gastric Cancer Patients  

PubMed Central

The role of HER-2 expression as a prognostic factor in gastric cancer (GC) is still controversial. The aim of the study was to asses HER-2 status, its correlations with clinicopathological parameters, and prognostic impact in GC patients. Tumor samples were collected from 78 patients who had undergone curative surgery. In order to evaluate the intensity of immunohistochemical (IHC) reactions two scales were applied: the immunoreactive score according to Remmele modified by the authors and standardised Hercep test score modified for GC by Hofmann et al. The HER-2 overexpression was detected by IHC in 23 (29.5%) tumors in Hercep test (score 2+/3+) and in 24 (30.7%) in IRS scale (IRS 4–12). The overexpression of HER-2 was associated with poorly differentiated tumors, but this correlation was not significant (P = 0.064). No relationship was found between HER-2 expression and primary tumor size and degree of spread to regional lymph nodes. Both univariate and multivariate analyses revealed that TNM stage and patient's age were the crucial negative prognostic factors. No correlation was observed between patient survival and expression of HER-2 estimated using both scales. This research did not confirm HER-2 expression (evaluated with immunohistochemistry) value as a prognostic tool in GC.

Halon, Agnieszka; Donizy, Piotr; Biecek, Przemyslaw; Rudno-Rudzinska, Julia; Kielan, Wojciech; Matkowski, Rafal



Prognostic factors in patients with jaw sarcomas.  


The aim of this study was to identify the prognostic factors related to the survival of patients with sarcomas of the jaw treated in the Dr. Eduardo Caceres Graziani National Institute for Neoplastic Diseases, Lima, Peru. Age, gender, delay in consultation, diagnostic delay, therapeutic delay, tumor size, tumor location, facial asymmetry, pain, treatment type, and histopathological diagnosis were all evaluated as possible prognostic factors that would influence survival in those with jaw sarcomas. In the analysis, the following was used: mortality tables, Kaplan-Meier's product-limit method, log-rank, and Breslow and Tarone-Ware tests; for the prognostic factors, Cox's Regression Model was used. The overall survival rate, with the patient being free from disease at two years, was 55%, and that at five years was 45%. In the independent analysis of the prognostic factors, four variables were statistically significant in influencing survival: gender (p = 0.043), histopathologic diagnosis (p = 0.019), tumor location (p = 0.019), and treatment type (p = 0.030). According to Cox's Regression Model for the multivariate analysis, statistically significant prognostic factors were: gender (p = 0.086), tumor location (p = 0.020), and treatment type (p = 0.092). Thus, the variables of gender, tumor location, and treatment type were determined to be predictive factors for prognosis of survival. PMID:22031055

Vadillo, Rafael Morales; Contreras, Sonia Julia Sacsaquispe; Canales, Janet Ofelia Guevara


CD69 is independently prognostic in chronic lymphocytic leukemia: a comprehensive clinical and biological profiling study  

PubMed Central

Background CD69 is expressed in several hemopoietic cells and is an early activation marker in chronic lymphocytic leukemia. Chronic lymphocytic leukemia is a clinically heterogeneous disease which needs novel prognostic parameters which can be easily and efficiently managed. Design and Methods We investigated CD69 by flow cytometry in a series of 417 patients affected by chronic lymphocytic leukemia and compared this to other biological and clinical prognosticators. Results CD69 was associated with Rai stages (P=0.00002), ?2-microglobulin (P=0.0005) and soluble CD23 (P<0.0001). CD69 and ZAP-70 (P=0.018) or CD38 (P=0.00015) or immunoglobulin variable heavy chain gene mutations (P=0.0005) were also significantly correlated. Clinically, CD69 positive chronic lymphocytic leukemias received chemotherapy more frequently (74%; P<0.0001), and presented a shorter duration of response after fludarabine plus rituximab (P=0.010) as well as shorter progression free survival and overall survival (P<0.0001). CD69 demonstrated true additive prognostic properties, since the CD69+ plus ZAP-70+ or CD38+ or immunoglobulin variable heavy chain gene unmutated patients had the worst progression free survival and overall survival (P<0.0001). Interestingly, low CD69 expression was necessary to correctly prognosticate the longer progression free survival of patients with a low tumor burden of ?2-microglobulin (P=0.002), of soluble CD23 (P=0.020), or of Rai stages 0-I (P=0.005). CD69 was confirmed to be an independent prognostic factor in multivariate analysis of progression free survival (P=0.017) and overall survival (P=0.039). Conclusions Our data indicate that CD69 is significantly correlated with poor clinical and biological prognostic factors and is confirmed to be an independent disease prognosticator. This supports its introduction in a routine laboratory assessment and, possibly, in a prognostic scoring system for chronic lymphocytic leukemia, after an adequate standardization process.

Del Poeta, Giovanni; Del Principe, Maria Ilaria; Zucchetto, Antonella; Luciano, Fabrizio; Buccisano, Francesco; Maria Rossi, Francesca; Bruno, Antonio; Biagi, Annalisa; Bulian, Pietro; Maurillo, Luca; Neri, Benedetta; Bomben, Riccardo; Simotti, Cristina; Coletta, Angela Maria; Dal Bo, Michele; de Fabritiis, Paolo; Venditti, Adriano; Gattei, Valter; Amadori, Sergio



High RSF-1 expression correlates with poor prognosis in patients with gastric adenocarcinoma  

PubMed Central

Aim To investigate the expression and prognostic significance of RSF-1 in gastric adenocarcinoma. Methods RSF-1 expression was analyzed using immunohistochemical staining on tissue samples from a consecutive series of 287 gastric adenocarcinoma patients who underwent tumor resections between 2003 and 2006.The relationship between RSF-1 expression, clinicopathological factors, and patient survival was investigated. Results Immunohistochemical staining indicated that RSF-1 is highly expressed in 52.6% of gastric adenocarcinomas. RSF-1 expression levels were closely associated with tumor size, histological differentiation, tumor stage, and lymph node involvement. Kaplan-Meier survival analysis showed that high RSF-1 expression exhibited a significant correlation with poor prognosis for gastric adenocarcinoma patients. Multivariate analysis revealed that RSF-1 expression is an independent prognostic parameter for the overall survival rate of gastric adenocarcinoma patients. Conclusion Our data suggest that RSF-1 plays an important role in gastric adenocarcinoma progression and that high RSF-1 expression predicts an unfavorable prognosis in gastric adenocarcinoma patients.

Hu, Ben-Shun; Yu, Hai-Feng; Zhao, Gao; Zha, Tian-Zhou



Prognostic significance of alterations in KRAS isoforms KRAS-4A/4B and KRAS mutations in colorectal carcinoma.  


Somatic KRAS mutation is an early well-known event in colorectal carcinogenesis but a complete understanding of RAS function and dysfunction in colorectal cancer is still to come. Our aim was to study the incidence of KRAS mutation; KRAS splice variants: KRAS4A and KRAS4B; and their relationships with various clinico-pathological characteristics in colorectal cancer (CRC).In this study, 285 CRC cases were analysed for KRAS mutation by direct DNA sequencing followed by immunohistochemical analysis after validation with real-time PCR assay, to study the protein expression of KRAS4A and -4B isoforms. KRAS gene mutations were seen in 80/285 CRCs (28.1%) and of the mutated cases, the majority of the mutations were seen in codon 12 (81.2%) as opposed to codon 13 (18.8%). CRCs with KRAS mutations were associated with a poor overall survival (p = 0.0009). Furthermore, KRAS mutations at codon 12 were associated with a poor overall survival of 64.4% at 5 years compared with a 5-year overall survival of 75.8% and 78.2% with codon 13 mutation and absence of KRAS mutations, respectively (p = 0.0025). KRAS4A protein expression was predominantly seen in the cytoplasm, while KRAS4B protein was nuclear. KRAS4A overexpression was significantly associated with left colon, histology subtype of adenocarcinoma, p27kip1, and cleaved caspase3 expression. Interestingly, KRAS4A overexpression was associated with a better overall survival (p = 0.0053). On the other hand, KRAS4B overexpression (33.2%) was significantly associated with larger tumour size (p = 0.0234) and inversely correlated with p27kip1 protein (p = 0.0159). Both KRAS mutation and KRAS4A were independent prognostic markers in a multivariate analysis with age, gender, stage, differentiation, and MSI status. Our results highlight the differential role of KRAS isoforms in CRC, their utility as a prognostic biomarker, and underline the importance of KRAS alterations as a potential therapeutic target for CRC. PMID:19824059

Abubaker, Jehad; Bavi, Prashant; Al-Haqawi, Wael; Sultana, Mehar; Al-Harbi, Sayer; Al-Sanea, Nasser; Abduljabbar, Alaa; Ashari, Luai H; Alhomoud, Samar; Al-Dayel, Fouad; Uddin, Shahab; Al-Kuraya, Khawla S



Clinicopathological Characteristics in Combined Hepatocellular-Cholangiocarcinoma: A Single Center Study in Korea  

PubMed Central

Purpose Combined hepatocellular-cholangiocarcinoma (CHCC) is an uncommon form of cancer, and its clinicopathological features have rarely been reported in detail. This study was undertaken to evaluate the clinicopathological characteristics and prognostic factors of CHCC. Materials and Methods The clinicopathological features of patients diagnosed with CHCC at Severance Hospital between January 1996 and December 2007 were retrospectively studied by comparing them with the features of patients with hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) who had undergone a hepatic resection during the same period. Results Forty-three patients diagnosed with CHCC were included in this study (M : F=35 : 8, median age, 55 years). According to the parameters of the American Joint Committee on Cancer staging, there were 6 (14.0%), 9 (20.9%), 25 (58.1%), and 3 (7.0%) patients with stages I, II, III, and IV cancer, respectively. Thirty-two of the 43 patients underwent resection with curative intent. After resection, 27 patients (84.4%) had tumor recurrence during the follow-up period of 18 months (range: 6-106 months), and the median time to recurrence was 13 months. Overall median survival periods after hepatic resection of CHCC, HCC and CC were 34, 103 and 38.9 months, respectively (p<0.001). The median overall survival for all patients with CHCC was 21 months, and the 5-year survival rate was 18.1%. The presence of portal vein thrombosis and distant metastasis were independent prognostic factors of poor survival. Conclusion Even after curative hepatic resection, the presence of a cholangiocellular component appeared to be a poor prognostic indicator in patients with primary liver cancer.

Park, Hana; Choi, Ki Hong; Choi, Sae-Byeol; Choi, Jong Won; Kim, Do Young; Ahn, Sang Hoon; Kim, Kyung Sik; Choi, Jin Sub; Han, Kwang-Hyub; Chon, Chae Yoon



Prognostic factors in tongue cancer - relative importance of demographic, clinical and histopathological factors  

PubMed Central

The incidence of and mortality from squamous cell carcinoma (SCC) of the tongue have increased during the recent decades in the Western world. Much effort has been made to predict tumour behaviour, but we still lack specific prognostic indicators. The aim of our study was to evaluate the relative importance of the known demographic, clinical and histological factors in a homogeneous population-based group of patients with SCC of the mobile tongue. The demographic and clinical factors were reviewed retrospectively from primary and tertiary care patient files. Histological prognostic factors were determined from pre-treatment biopsies. The TNM stage was found to be the most important prognostic factor. In particular, local spread outside the tongue rather than spread to regional lymph nodes was related to poor prognosis. Several demographic and histopathological factors were closely related to TNM stage. When the cases were divided into stage I–II carcinomas and stage III–IV carcinomas, it appeared that the patient’s older age (> 65 years), a high malignancy score and an absence of overexpressed p53 protein were associated with a poorer prognosis in stage I–II carcinomas. Such cases may require more aggressive treatment. Among patients with stage III–IV carcinomas, heavy use of alcohol was significantly associated with a poor disease-specific survival time. © 2000 Cancer Research Campaign

Kantola, S; Parikka, M; Jokinen, K; Hyrynkangs, K; Soini, Y; Alho, O-P; Salo, T



Clinical features and prognostic factors in patients with carcinomatous meningitis secondary to breast cancer.  


Prognosis in patients with carcinomatous meningitis (CM) is poor, and numerous prognostic factors for response and survival have been described, but remain controversial. In general, series are small and involve a heterogeneous type of solid neoplasms. The purpose of this study was to describe a series of patients with breast cancer-associated CM to determine the clinical features and prognostic factors associated with survival. We conducted a retrospective study on 49 patients diagnosed between January 2003 and December 2007 at the Instituto Nacional de Cancerología in Mexico City. CSF cytopathology samples were re-reviewed to confirm the diagnosis. Overall survival (OS) for patients with breast cancer with CM was 7 weeks. Factors independently associated with better OS included absence of encephalopathy at diagnosis (11 weeks versus 1 week; p?=?.036), low CSF protein content (15 versus 5 weeks; p?= .022), and nontriple-negative receptor status in the primary breast cancer tumor (13 versus 3 weeks; p?=?.015). According to multivariate analysis, patients were divided into favorable and poor prognostic groups, with OS of 14 weeks and 2 weeks, respectively (p?

Lara-Medina, Fernando; Crismatt, Alejandro; Villarreal-Garza, Cynthia; Alvarado-Miranda, Alberto; Flores-Hernández, Lorena; González-Pinedo, Marcelino; Gamboa-Vignolle, Carlos; Ruiz-González, J D Salvador; Arrieta, Oscar



KL-6, a Human MUC1 Mucin, as a prognostic marker for diffuse alveolar hemorrhage syndrome  

PubMed Central

Background Diffuse alveolar hemorrhage syndrome is a life threatening condition with diverse etiologies. Sensitive prognostic markers for diffuse alveolar hemorrhage have not been well investigated. Serum KL-6 is a biomarker for various interstitial lung disease associated with disease activity and prognosis. The purpose of the present study was to evaluate the clinical utility of serum KL-6 level as a prognostic marker for diffuse alveolar hemorrhage. Methods We retrospectively collected 41 consecutive patients clinically diagnosed as having diffuse alveolar hemorrhage who were admitted to the Intensive Care Unit of Hiroshima University Hospital between 2004 and 2011. Correlation between prognosis and age, sex, laboratory findings including serum KL-6, radiological findings, ventilatory modes or therapeutic regimens were evaluated. Results Baseline and peak serum KL-6 levels were significantly higher in non-survivors compared with survivors. An increase in KL-6 levels during the initial week was associated with a subsequent deterioration of the oxygenation index. Higher baseline KL-6 levels and higher peak KL-6 levels were strongly correlated with death. With a cut-off level of 700 U/mL for peak KL-6, the sensitivity, specificity and accuracy for non-survival were 75%, 85% and 78%, respectively. In the multivariate analysis, only the peak KL-6 level ?700 U/ml was an independent poor prognostic factor for diffuse alveolar hemorrhage. Conclusions Peak serum KL-6 level ?700 U/ml may become a clinically useful marker of poor prognosis for diffuse alveolar hemorrhage.



Prognostic Factors Related to Surgical Outcome of Liver Metastases of Breast Cancer  

PubMed Central

Purpose The role of hepatectomy for patients with liver metastases of breast cancer (LMBC) remains controversial. The purpose of this study is to share our experience with hepatic resection in a relatively unselected group of patients with LMBC and analyse the prognostic factors and indications for surgery. Methods In 2000 to 2006, 42 female patients with a mean age of 58.2 years (range, 39 to 69 years) with LMBC diagnosed by means of abdominal ultrasound, computed tomography and/or magnetic resonance imaging in the hospital. They were considered for surgery because of limited comorbidities, presence of seven or fewer liver tumors and absence of (or limited and stable) extrahepatic disease on preoperative imaging. Patients' demographics, metastatic characteristics as well as clinical and operative parameters were being studied. Overall actuarial 1-, 3-, and 5-year survival rates were calculated since the hepatic resection onwards using the Kaplan-Meier method. Results Metastatic tumor size of ?4 cm (p=0.03), R0 resection (p=0.02), negative portal lymph nodes (p=0.01), response to chemotherapy (p=0.02), and positive hormone receptor status (p=0.03) were associated with better survival outcomes on univariate analysis. However, it did not show survival benefits on multivariate analysis. The disease-free survival and overall survival are 29.40 and 43 months, respectively. The 1-, 3- and 5-year survival rates were 84.61%, 64.11%, and 38.45%, respectively. Conclusion Selected patients with isolated LMBC may benefit from surgical management; although, indications remain unclear and the risks may outweigh the benefits in patients with a generally poor prognosis. Improvements in preoperative staging and progressive application of new multimodality treatments will be the key to improved survival rates in this severe disease. The careful selection of patients is associated with a satisfactory long-term survival rate.

Kobakov, Georgi L.; Yankov, Daniel V.



Do Middle-Class Students Perceive Poor Women and Poor Men Differently?  

Microsoft Academic Search

In this study, we examined attitudes toward poor women, stereotypes about them, attributions for their poverty, and whether these thoughts and feelings differ from those about poor men. In our Midwestern college students sample (n = 206), attitudes toward poor women were significantly more positive than attitudes toward poor men. In addition, stereotypes of poor women were both more positive

Catherine Cozzarelli; Michael J. Tagler; Anna V. Wilkinson



Management of metastatic renal cell carcinoma patients with poor-risk features: current status and future perspectives.  


With seven agents approved for renal cell carcinoma within the past few years, there has undoubtedly been progress in treating this disease. However, patients with poor-risk features remain a challenging and difficult-to-treat population, with the mTOR inhibitor, temsirolimus, the only agent approved in the first-line setting. Phase III trial data are still lacking VEGF-pathway inhibitors in patients with poor prognostic features. Poor-risk patients need to be considered as a heterogeneous population. Further understanding of biomarkers can lead to a better selection of patients who may benefit the most from treatment and improvements in prognosis. The presence of poor Karnofsky scores and liver or CNS disease may affect the outcome of these patients much more than other identified factors. This consideration may provide the rationale to further stratify poor-risk patients further subgroups destined to receive either cure or palliation. PMID:23773104

Santoni, Matteo; De Tursi, Michele; Felici, Alessandra; Lo Re, Giovanni; Ricotta, Riccardo; Ruggeri, Enzo Maria; Sabbatini, Roberto; Santini, Daniele; Vaccaro, Vanja; Milella, Michele



Validation of podocalyxin-like protein as a biomarker of poor prognosis in colorectal cancer  

PubMed Central

Background Podocalyxin-like 1 (PODXL) is a cell-adhesion glycoprotein and stem cell marker that has been associated with an aggressive tumour phenotype and adverse outcome in several cancer types. We recently demonstrated that overexpression of PODXL is an independent factor of poor prognosis in colorectal cancer (CRC). The aim of this study was to validate these results in two additional independent patient cohorts and to examine the correlation between PODXL mRNA and protein levels in a subset of tumours. Method PODXL protein expression was analyzed by immunohistochemistry in tissue microarrays with tumour samples from a consecutive, retrospective cohort of 270 CRC patients (cohort 1) and a prospective cohort of 337 CRC patients (cohort 2). The expression of PODXL mRNA was measured by real-time quantitative PCR in a subgroup of 62 patients from cohort 2. Spearman´;s Rho and Chi-Square tests were used for analysis of correlations between PODXL expression and clinicopathological parameters. Kaplan Meier analysis and Cox proportional hazards modelling were applied to assess the relationship between PODXL expression and time to recurrence (TTR), disease free survival (DFS) and overall survival (OS). Results High PODXL protein expression was significantly associated with unfavourable clinicopathological characteristics in both cohorts. In cohort 1, high PODXL expression was associated with a significantly shorter 5-year OS in both univariable (HR?=?2.28; 95% CI 1.43-3.63, p?=?0.001) and multivariable analysis (HR?=?2.07; 95% CI 1.25-3.43, p?=?0.005). In cohort 2, high PODXL expression was associated with a shorter TTR (HR?=?2.93; 95% CI 1.26-6.82, p?=?0.013) and DFS (HR?=?2.44; 95% CI 1.32-4.54, p?=?0.005), remaining significant in multivariable analysis, HR?=?2.50; 95% CI 1.05-5.96, p?=?0.038 for TTR and HR?=?2.11; 95% CI 1.13-3.94, p?=?0.019 for DFS. No significant correlation could be found between mRNA levels and protein expression of PODXL and there was no association between mRNA levels and clinicopathological parameters or survival. Conclusions Here, we have validated the previously demonstrated association between immunohistochemical expression of PODXL and poor prognosis in CRC in two additional independent patient cohorts. The results further underline the potential utility of PODXL as a biomarker for more precise prognostication and treatment stratification of CRC patients.



Progesterone receptor status is a significant prognostic variable of progression-free survival in advanced epithelial ovarian cancer.  


The purpose of this study was to determine if tumor estrogen receptor (ER) or progesterone receptor (PR) status were significant prognostic variables of survival and progression-free survival among patients with International Federation of Gynecology and Obstetrics (FIGO) stage III and IV epithelial ovarian cancer. Tumor steroid receptor status was evaluated among 67 consecutive patients who underwent primary surgery from June 1983 through September 1990. Characteristics of receptor-negative and receptor-positive populations were compared by chi-square analysis. Univariate and multivariate analyses were used to identify variables prognostic of survival and progression-free survival. Fifty-one of 67 patients (76.1%) had ER-positive tumors and 31 (46.3%) patients had PR-positive tumors. Significant differences between receptor-positive and receptor-negative populations were not observed. Neither univariate nor multivariate analysis identified ER or PR status as significant prognostic variables of survival (p = 0.93 and p = 0.06, respectively). Progesterone receptor-positive status was a significant prognostic variable of progression-free survival in both univariate (p = 0.03) and multivariate (p = 0.04) analyses even after adjustment for residual disease and patient age. Estrogen receptor status was not a significant prognostic indicator of progression-free survival in either univariate or multivariate analyses. Progesterone receptor-positive tumor status is shown to be an independent prognostic variable of improved progression-free survival among patients with advanced epithelial ovarian cancer. PMID:9781597

Hempling, R E; Piver, M S; Eltabbakh, G H; Recio, F O



Papillary Serous and Clear Cell Type Lead to Poor Prognosis of Endometrial Carcinoma in Black Women  

Microsoft Academic Search

Objective:To investigate the significance of race and histologic type as prognostic factors in endometrial carcinoma.Methods:We conducted a retrospective review of the medical records of all patients diagnosed with endometrial cancer from 1982 to 1995. Patients’ clinical and pathologic characteristics were analyzed.Results:The sample consisted of 401 patients, 59.9% (N= 229) were blacks and 40.1% (N= 153) were non-blacks. The mean age

Roland P. Matthews; Juana Hutchinson-Colas; Mitchell Maiman; Rachel G. Fruchter; E. Jason Gates; Darlene Gibbon; Jean Claude Remy; Alexander Sedlis



Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment  

PubMed Central

Lymph node status is the most significant prognostic factor of colorectal cancer. However, there is a risk of disease understaging if the extent of lymph node assessment is sub-optimal. Preoperative C-reactive protein (CRP) is known to be a useful tool in predicting postoperative outcomes in patients with colorectal cancer. We retrospectively evaluated whether CRP adds to prognosis information in stage I–III colorectal cancer patients with poor lymph node assessment. In stages I–III, multivariate analysis revealed that CRP-positive status and advanced T-stage were factors that independently affected survival. In stage III, univariate analysis revealed that lymph node number retrieval and lymph node ratio were factors that affected survival. However, CRP positivity was the only independent factor for survival. CRP positivity did not predict poor prognosis in stage II or III patients with adequate lymph node retrieval. By contrast, the prognosis of CRP-positive patients was poorer than that of CRP-negative patients in stage II and III, with inadequate lymph node retrieval. CRP is an independent prognostic marker in patients with stage I–III, II or III colorectal cancer. The evaluation of CRP may provide useful information on prognosis in curative patients with an inadequate examination of lymph nodes.




Prognostic utility of pre-operative circulating osteopontin, carbonic anhydrase IX and CRP in renal cell carcinoma  

PubMed Central

Background: Objectively measured circulating biomarkers of prognosis complementing existing clinicopathological models are needed in renal cell carcinoma (RCC). Methods: Blood samples collected from 216 RCC patients in Leeds before nephrectomy (median follow-up 7 years) were analysed for C-reactive protein (CRP), osteopontin (OPN) and carbonic anhydrase IX (CA9) and prognostic significance determined. Results: CA9, OPN and CRP were univariately prognostic for overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) with CRP and CA9 being independently prognostic for OS/CSS and OS, respectively. Including CA9, OPN and CRP with other conventional prognostic factors gave a superior predictive capacity when compared with a previously published pre-operative clinical nomogram (Karakiewicz et al, 2009). Osteopontin outperformed this nomogram and the post-operative SSIGN score for OS but not for CSS, being significantly predictive for non-cancer deaths. Osteopontin, CRP and CA9 outperformed stage (c-index 76% compared with 70% for stage) and OPN or CA9 identified several subsets of poor prognosis patients including in T1 patients, who may benefit from adjuvant therapy and increased surveillance. Conclusion: Circulating CA9, OPN and CRP add value to existing clinicopathological prognostic factors/models and support further studies to investigate their potential use in improving the clinical management of RCC.

Sim, S H; Messenger, M P; Gregory, W M; Wind, T C; Vasudev, N S; Cartledge, J; Thompson, D; Selby, P J; Banks, R E



A new biologic prognostic model based on immunohistochemistry predicts survival in patients with diffuse large B-cell lymphoma  

PubMed Central

Biologic factors that predict the survival of patients with a diffuse large B-cell lymphoma, such as cell of origin and stromal signatures, have been discovered by gene expression profiling. We attempted to simulate these gene expression profiling findings and create a new biologic prognostic model based on immunohistochemistry. We studied 199 patients (125 in the training set, 74 in the validation set) with de novo diffuse large B-cell lymphoma treated with rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP-like therapies, and immunohistochemical stains were performed on paraffin-embedded tissue microarrays. In the model, 1 point was awarded for each adverse prognostic factor: nongerminal center B cell–like subtype, SPARC (secreted protein, acidic, and rich in cysteine) < 5%, and microvascular density quartile 4. The model using these 3 biologic markers was highly predictive of overall survival and event-free survival in multivariate analysis after adjusting for the International Prognostic Index in both the training and validation sets. This new model delineates 2 groups of patients, 1 with a low biologic score (0-1) and good survival and the other with a high score (2-3) and poor survival. This new biologic prognostic model could be used with the International Prognostic Index to stratify patients for novel or risk-adapted therapies.

Perry, Anamarija M.; Cardesa-Salzmann, Teresa M.; Meyer, Paul N.; Colomo, Luis; Smith, Lynette M.; Fu, Kai; Greiner, Timothy C.; Delabie, Jan; Gascoyne, Randy D.; Rimsza, Lisa; Jaffe, Elaine S.; Ott, German; Rosenwald, Andreas; Braziel, Rita M.; Tubbs, Raymond; Cook, James R.; Staudt, Louis M.; Connors, Joseph M.; Sehn, Laurie H.; Vose, Julie M.; Lopez-Guillermo, Armando; Campo, Elias; Chan, Wing C.



Prognostic factors in anal squamous carcinoma: a multivariate analysis of clinical, pathological and flow cytometric parameters in 235 cases.  


Clinical, pathological and flow cytometric parameters have been analysed by univariate and multivariate analysis to define those parameters of important prognostic influence in 235 cases of surgically treated squamous carcinoma of the anus and perianal skin. Patients had been treated by anorectal excision (166 patients) or by local excision (69). Analyses were carried out on five data sets--the two surgical subgroups, two groups distinguished by site of tumour and on all 235 patients. Univariate analysis showed many parameters to be of prognostic influence, although histological typing of tumours into the more common histological subtypes was of no prognostic value. Parameters of independent prognostic significance in multivariate analysis were those indicating depth of spread, inguinal lymph node involvement and DNA-ploidy. In this study the subdivision of the rarer types of anal canal tumour, such as mucoepidermoid carcinoma, microcystic squamous carcinoma and small cell anaplastic carcinoma, was relevant confirming that these tumours have a poor prognosis. It is now felt that surgery should not be employed as primary treatment in most cases of anal cancer and the results of this study have to be interpreted with caution when applied to patients treated with radiotherapy with or without chemotherapy. Nevertheless, our findings suggest that the most useful prognostic information can be gleaned from accurate clinical staging and an assessment of DNA-ploidy status. PMID:2376397

Shepherd, N A; Scholefield, J H; Love, S B; England, J; Northover, J M



A new biologic prognostic model based on immunohistochemistry predicts survival in patients with diffuse large B-cell lymphoma.  


Biologic factors that predict the survival of patients with a diffuse large B-cell lymphoma, such as cell of origin and stromal signatures, have been discovered by gene expression profiling. We attempted to simulate these gene expression profiling findings and create a new biologic prognostic model based on immunohistochemistry. We studied 199 patients (125 in the training set, 74 in the validation set) with de novo diffuse large B-cell lymphoma treated with rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP-like therapies, and immunohistochemical stains were performed on paraffin-embedded tissue microarrays. In the model, 1 point was awarded for each adverse prognostic factor: nongerminal center B cell-like subtype, SPARC (secreted protein, acidic, and rich in cysteine) < 5%, and microvascular density quartile 4. The model using these 3 biologic markers was highly predictive of overall survival and event-free survival in multivariate analysis after adjusting for the International Prognostic Index in both the training and validation sets. This new model delineates 2 groups of patients, 1 with a low biologic score (0-1) and good survival and the other with a high score (2-3) and poor survival. This new biologic prognostic model could be used with the International Prognostic Index to stratify patients for novel or risk-adapted therapies. PMID:22740447

Perry, Anamarija M; Cardesa-Salzmann, Teresa M; Meyer, Paul N; Colomo, Luis; Smith, Lynette M; Fu, Kai; Greiner, Timothy C; Delabie, Jan; Gascoyne, Randy D; Rimsza, Lisa; Jaffe, Elaine S; Ott, German; Rosenwald, Andreas; Braziel, Rita M; Tubbs, Raymond; Cook, James R; Staudt, Louis M; Connors, Joseph M; Sehn, Laurie H; Vose, Julie M; López-Guillermo, Armando; Campo, Elias; Chan, Wing C; Weisenburger, Dennis D



Patient-Specific Data Fusion Defines Prognostic Cancer Subtypes  

PubMed Central

Different data types can offer complementary perspectives on the same biological phenomenon. In cancer studies, for example, data on copy number alterations indicate losses and amplifications of genomic regions in tumours, while transcriptomic data point to the impact of genomic and environmental events on the internal wiring of the cell. Fusing different data provides a more comprehensive model of the cancer cell than that offered by any single type. However, biological signals in different patients exhibit diverse degrees of concordance due to cancer heterogeneity and inherent noise in the measurements. This is a particularly important issue in cancer subtype discovery, where personalised strategies to guide therapy are of vital importance. We present a nonparametric Bayesian model for discovering prognostic cancer subtypes by integrating gene expression and copy number variation data. Our model is constructed from a hierarchy of Dirichlet Processes and addresses three key challenges in data fusion: (i) To separate concordant from discordant signals, (ii) to select informative features, (iii) to estimate the number of disease subtypes. Concordance of signals is assessed individually for each patient, giving us an additional level of insight into the underlying disease structure. We exemplify the power of our model in prostate cancer and breast cancer and show that it outperforms competing methods. In the prostate cancer data, we identify an entirely new subtype with extremely poor survival outcome and show how other analyses fail to detect it. In the breast cancer data, we find subtypes with superior prognostic value by using the concordant results. These discoveries were crucially dependent on our model's ability to distinguish concordant and discordant signals within each patient sample, and would otherwise have been missed. We therefore demonstrate the importance of taking a patient-specific approach, using highly-flexible nonparametric Bayesian methods.

Markowetz, Florian



Hormone receptor expression in uterine sarcomas: prognostic and therapeutic roles.  


OBJECTIVES.: The utility of hormone therapy in the management of uterine sarcomas is poorly defined. We hypothesize that estrogen receptor (ER) expression is common in uterine sarcomas, and carries prognostic significance. Further, we hypothesize that ER-positive uterine sarcomas respond to hormone therapy. METHODS.: We retrospectively reviewed charts of patients with uterine sarcomas. Stepwise Cox proportional hazards regression model was used to evaluate variables related to the risk of death: age, histology, stage, use of pelvic radiotherapy, and ER expression. In addition, we examined clinical outcomes in patients treated with aromatase inhibitors, megestrol acetate, depot medroxyprogesterone acetate, and tamoxifen. RESULTS.: Fifty-four patients underwent immunohistochemical staining, and 34 (63%) were ER-positive. Kaplan-Meier survival analysis and log-rank test indicated that patients with ER-positive sarcomas demonstrated improved overall survival when compared with ER-negative patients (median OS 36 vs. 16 months, p=0.004). Upon multivariate analysis, ER positivity retained significance as an independent predictor of survival (HR=0.32, CI 0.12-0.89, p=0.03). Four patients received hormonal treatment in the adjuvant setting and remained in remission (range of follow up: 18-68 months). Eighteen patients received hormone therapy in the setting of recurrent or progressive disease: fourteen (78%) demonstrated stable disease or complete or partial response (range of follow up: 6-124 months). CONCLUSIONS.: ER expression is common and is associated with improved overall survival in uterine sarcomas. Conducting immunohistochemical staining to ascertain ER status may aid with prognostication in this disease. Hormone therapy should be considered in patients with primary and recurrent ER-positive uterine sarcomas. PMID:19767065

Ioffe, Y J; Li, A J; Walsh, C S; Karlan, B Y; Leuchter, R; Forscher, C; Cass, I



Treatment outcomes and prognostic factors of intrahepatic cholangiocarcinoma  

PubMed Central

The aim of the present study was to determine the treatment outcome and prognostic factors for survival in patients with peripheral intrahepatic cholangiocarcinoma (ICC). A retrospective chart review was performed for patients diagnosed with ICC between 2000 and 2009 at a single institution. We identified a total of 105 patients with ICC. Among them, 63.8% were older than 60 years of age, 50.5% were male and 88.6% were Caucasian. By preoperative imaging approximately half of the patients (50.5%) were surgical candidates and underwent resection. The other half of the patients (49.5%) were unresectable. The unresectable group received chemoradiotherapy (53%) and transarterial chemoembolization (7.7%) as palliative treatments while 23.0% of the patients (12/52) received best supportive care alone. The median survival rates were 16.1 months (13.1–19.2) for the entire cohort, 27.6 months (17.7–37.6) for curative resection, 12.9 months (6.5–19.2) for palliative chemoradiotherapy and 4.9 months (0.4–9.6) for best supportive care (P<0.001). Independent predictors on multivariate analysis were advanced stage at diagnosis and treatment received. In those patients who underwent resection, advanced AJCC stage and presence of microvascular invasion were also independent predictors of poor survival. We concluded that surgery offers the most beneficial curative option and outcome, emphasizing the importance of resectability as a major prognostic factor. The present study also revealed that use of chemoradiotherapy in the adjuvant setting failed to improve survival but its palliative use in those patients with unresectable ICC offered a modest survival advantage over best supportive care. The overriding factors influencing outcome were stage and the presence of microvascular invasion on pathology.




Interleukin-8 as a prognostic serum marker in canine mammary gland neoplasias.  


Mammary gland tumors in female dogs are an excellent model for the clinic-pathological, diagnostic and prognostic investigation of mammary neoplasias. Prognostic and predictive markers are effective in research and routine diagnosis. Interleukins play a fundamental role in cancer, with a particular function in tumor growth, invasion and metastatic potential. Interleukin-8 (IL-8) is known to possess tumorigenic and pro-angiogenic properties, and its overexpression is seen in a number of human tumors. IL-8 serum levels were determined and correlated with the clinic-pathological features and clinical evolution of mammary gland neoplasias in female dogs. IL-8 was measured by an immunoenzymatic assay in 30 female dogs with mammary neoplasias within a 12 month follow-up and in 50 control animals. The correlation between IL-8 concentration and clinical parameters was investigated. A statistically significant difference in the IL-8 serum levels was found in tumor-bearing dogs compared to the controls. In addition, when the individual parameters were evaluated, IL-8 content showed a positive correlation with the tumor progression, lymph node involvement, recurrence and death. Single and multivariate analyses showed associations between tumor recurrence, metastasis, high clinical staging and high IL-8, and also with the death risk. This was also consistent with the high IL-8 content in dogs showing tumor recurrence and metastasis. IL-8 superexpression has been detected in a number of human tumors, usually associated with a poor prognostic. Besides promoting angiogenesis, IL-8 is strongly related with the metastatic phenotype of mammary tumor cells. High IL-8 concentration was found in mammary gland cancer patients with advanced disease stages. Our results show that IL-8 can be used as a non-invasive prognostic marker for mammary gland cancer, and can be useful for the prediction of disease progression and recurrence in dogs with mammary neoplasias. The increased level of this cytokine acts as an independent prognostic marker of survival and the identification of animals with the poor prognostic. PMID:22405680

Gelaleti, Gabriela Bottaro; Jardim, Bruna Victorasso; Leonel, Camila; Moschetta, Marina Gobbe; Zuccari, Debora Ap Pires de Campos



Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma  

Microsoft Academic Search

We conducted a randomized trial to com- pare the intensive conventional chemo- therapy regimen ACVBP (doxorubicin, cy- clophosphamide, vindesine, bleomycin, prednisone) with standard CHOP (cyclo- phosphamide, doxorubicin, vincristine, and prednisone) in previously untreated patients with poor-risk aggressive lym- phoma. Patients aged 61 to 69 years who had aggressive non-Hodgkin lymphoma with at least one prognostic factor of the age-adjusted international

Eric Lepage; Bertrand Coiffier; Michel Blanc; Raoul Herbrecht; Michel Attal; Georges Fillet; Catherine Guettier; Thierry Jo Molina; Christian Gisselbrecht; Felix Reyes



IEEE standards for prognostics and health management  

Microsoft Academic Search

Recently, operators of complex systems such as aircraft, power plants, and networks, have been emphasizing the need for online health monitoring for purposes of maximizing operational availability and safety. The discipline of prognostics and health management (PHM) is being formalized to address the information management and prediction requirements for addressing these needs. In this paper, we will explore how standards

John W. Sheppard; Mark A. Kaufman; Timothy J. Wilmering



IEEE Standards for Prognostics and Health Management  

Microsoft Academic Search

Recently operators of complex systems such as aircraft, power plants, and networks have been emphasizing the need for on-line health monitoring for purposes of maximizing operational availability and safety. The discipline of prognostics and health management (PHM) is being formalized to address the information management and prediction requirements for addressing these needs. Herein, we will explore how standards currently under

John W. Sheppard; Mark A. Kaufman; T. J. Wilmer



Prognostic Analysis of the Tactical Quiet Generator  

SciTech Connect

The U.S. Army needs prognostic analysis of mission-critical equipment to enable condition-based maintenance before failure. ORNL has developed and patented prognostic technology that quantifies condition change from noisy, multi-channel, time-serial data. This report describes an initial application of ORNL's prognostic technology to the Army's Tactical Quiet Generator (TQG), which is designed to operate continuously at 10 kW. Less-than-full power operation causes unburned fuel to accumulate on internal components, thereby degrading operation and eventually leading to failure. The first objective of this work was identification of easily-acquired, process-indicative data. Two types of appropriate data were identified, namely output-electrical current and voltage, plus tri-axial acceleration (vibration). The second objective of this work was data quality analysis to avoid the garbage-in-garbage-out syndrome. Quality analysis identified more than 10% of the current data as having consecutive values that are constant, or that saturate at an extreme value. Consequently, the electrical data were not analyzed further. The third objective was condition-change analysis to indicate operational stress under non-ideal operation and machine degradation in proportion to the operational stress. Application of ORNL's novel phase-space dissimilarity measures to the vibration power quantified the rising operational stress in direct proportion to the less-than-full-load power. We conclude that ORNL's technology is an excellent candidate to meet the U.S. Army's need for equipment prognostication.

Hively, Lee M [ORNL



Circuit breaker prognostics using SF6 data  

Microsoft Academic Search

Control decisions within future energy networks may take account of the health and condition of network assets, pushing condition monitoring within the smart grid remit. In order to support maintenance decisions, this paper proposes a circuit breaker prognostic system, which ranks circuit breakers in order of maintenance priority. By monitoring the SF6 density within a breaker, the system not only

S. E. Rudd; V. M. Catterson; S. D. J. McArthur; C. Johnstone



Prognostic factors in radical cystectomy affecting survival  

PubMed Central

Introduction The aim of the study was to evaluate the prognostic factors in radical cystectomy affecting survival. Material and methods A total of 100 hundred patients were included in the study. Incontinent diversion was applied to 73 of these, and continent diversion to 27. Prospective and retrospective data of the patients were examined. The prognostic value for survival was evaluated for of lymph node involvement, tumor grade (low grade: grade 0-II, high grade: ? III or epidermoid carcinoma), tumor stage (low stage: stage pT0-2, high stage: stage ? 3a pT3a), presence of preoperative unilateral of bilateral hydronephrosis, presence of preoperative uremia (serum urea value: ? 60), and age (> 70 and ? 70 years of age) on survival were investigated. Kaplan-Meier survival analysis and Log-Rank statistical methods were used in the study. Results Grade, stage, uremia, and lymph node involvement had significant effects on survival (p values 0.0002, 0.03, 0.01, and 0.02, respectively). Presence of preoperative hydronephrosis and age had no statistically significant effects on survival (p values 0.8 and 0.2, respectively). Conclusions Tumor grade, tumor stage, preoperative uremia, and lymph node involvement are prognostic factors affecting survival. Advanced age and presence of preoperative hydronephrosis have no prognostic value for survival. The presence of uremia in the preoperative assessment of the patients is more important than hydronephrosis.

Aglamis, Erdogan; Toktas, Gokhan; Unluer, Erdinc; Ceylan, Cavit



Prognostic and health management for avionics  

Microsoft Academic Search

This paper describes methodologies and tools to anticipate in real-time, the onset of failures in electronic equipment. Currently developed techniques for prognostics and health management (PHM), depend on the observation of precursor variables and an imputation from them of impending failure. In electronic systems, such variables are difficult, impossible or expensive to obtain, so we propose a model-based technique utilizing

Chris Wilkinson; Dave Humphrey; Bert Vermeire; J. Houston



Frequent Gene Amplification Predicts Poor Prognosis in Gastric Cancer  

PubMed Central

Gastric cancer is one of the most common malignancies worldwide. However, genetic alterations leading to this disease are largely unknown. Gene amplification is one of the most frequent genetic alterations, which is believed to play a major role in the development and progression of gastric cancer. In the present study, we identified three frequently amplified genes from 30 candidate genes using real-time quantitative PCR method, including ERBB4, C-MET and CD44, and further explored their association with clinicopathological characteristics and poor survival in a cohort of gastric cancers. Our data showed amplification of these genes was significantly associated with certain clinicopathological characteristics, particularly tumor differentiation and cancer-related death. More importantly, amplification of these genes was significantly related to worse survival, suggesting that these amplified genes may be significant predictors of poor prognosis and potential therapeutic targets in gastric cancer. Targeting these genes may thus provide new possibilities in the treatment of gastric cancer.

Shi, Jing; Yao, Demao; Liu, Wei; Wang, Na; Lv, Hongjun; He, Nongyue; Shi, Bingyin; Hou, Peng; Ji, Meiju



Survival Analysis of Genome-Wide Gene Expression Profiles of Prostate Cancers Identifies New Prognostic Targets of Disease Relapse1,2  

Microsoft Academic Search

Current models of prostate cancer classification are poor at distinguish- ing between tumors that have similar histopathological features but vary in clinical course and outcome. Here, we applied classical survival analysis to genome-wide gene expression profiles of prostate cancers and pre- operative prostate-specific antigen (PSA) levels from each patient, to identify prognostic markers of disease relapse that provide additional predictive

Susan M. Henshall; Daniel E. H. Afar; Jordan Hiller; Lisa G. Horvath; David I. Quinn; Krishan K. Rasiah; Kurt Gish; Dorian Willhite; James G. Kench; Margaret Gardiner-Garden; Phillip D. Stricker; Howard I. Scher; John J. Grygiel; David B. Agus; David H. Mack; Robert L. Sutherland



Low BRMS1 expression promotes nasopharyngeal carcinoma metastasis in vitro and in vivo and is associated with poor patient survival  

PubMed Central

Background Breast cancer metastasis suppressor 1 (BRMS1) is a metastasis suppressor gene. This study aimed to investigate the impact of BRMS1 on metastasis in nasopharyngeal carcinoma (NPC) and to evaluate the prognostic significance of BRMS1 in NPC patients. Methods BRMS1 expression was examined in NPC cell lines using quantitative reverse transcription-polymerase chain reaction and Western blotting. NPC cells stably expressing BRMS1 were used to perform wound healing and invasion assays in vitro and a murine xenograft assay in vivo. Immunohistochemical staining was performed in 274 paraffin-embedded NPC specimens divided into a training set (n?=?120) and a testing set (n?=?154). Results BRMS1 expression was down-regulated in NPC cell lines. Overexpression of BRMS1 significantly reversed the metastatic phenotype of NPC cells in vitro and in vivo. Importantly, low BRMS1 expression was associated with poor distant metastasis-free survival (DMFS, P?poor overall survival (OS, P?prognostic factor for DMFS and OS in NPC. Conclusions Low expression of the metastasis suppressor BRMS1 may be an independent prognostic factor for poor prognosis in NPC patients.



Involvement of Difference in Decrease of Hemoglobin Level in Poor Prognosis of Stage I and II Nasopharyngeal Carcinoma: Implication in Outcome of Radiotherapy  

SciTech Connect

Purpose: To investigate the effect of hemoglobin (Hb) concentration and the difference in its decrease during treatment on outcome of radiotherapy (RT) alone for patients with Stage I and II nasopharyngeal carcinoma. Methods and Materials: A total of 572 patients with Stage I-II nasopharyngeal carcinoma with RT alone between January 2001 and December 2004 were retrospectively analyzed. Patient characteristics, tumor variables, and Hb level, including pre-RT Hb, mid-RT Hb, and dynamic change of Hb between pre- and post- RT and its difference in decrease ( White-Up-Pointing-Small-Triangle Hb) were subjected to univariate and multivariable analysis to identify factors that predict disease-specific survival (DSS), local regional recurrence-free survival (LRFS), and metastases-free survival (MFS). Results: The 5-year DSS was poorer in the Hb continuous decrease group than in the Hb noncontinuous decrease group (84% vs. 89%; p = 0.008). There was poorer 5-year DSS in patients with White-Up-Pointing-Small-Triangle Hb of >11.5 g/L than in those with White-Up-Pointing-Small-Triangle Hb of {<=}11.5 g/L (82% vs. 89%; p = 0.001), and poorer LRFS (79% vs. 83%; p = 0.035). Univariate and multivariate analysis showed that Hb decrease difference with greater than 11.5 g/L was an independent prognostic factor for DSS and LRFS. Conclusions: The difference in decrease of Hb level during the course of radiation treatment appeared as a poor prognostic factor in Stage I and II nasopharyngeal carcinoma patients.

Gao Jin [Department of Radiation Oncology, Cancer Center, Sun Yat-Sen University, Guangzhou (China); State Key Laboratory of Oncology in Southern China, Sun Yat-Sen University, Guangzhou (China); Department of Radiation Oncology, Anhui provincial hospital, Hefei (China); Tao Yalan; Li Guo; Yi Wei [Department of Radiation Oncology, Cancer Center, Sun Yat-Sen University, Guangzhou (China); State Key Laboratory of Oncology in Southern China, Sun Yat-Sen University, Guangzhou (China); Xia Yunfei, E-mail: [Department of Radiation Oncology, Cancer Center, Sun Yat-Sen University, Guangzhou (China); State Key Laboratory of Oncology in Southern China, Sun Yat-Sen University, Guangzhou (China)



Clinical Manifestations and Prognostic Factor of Iliopsoas Abscess  

PubMed Central

Introduction: Iliopsoas abscess (IPA) is a collection of pus in the iliopsoas compartment, which is considered rare in Japan. However, the number of patients with IPA has recently increased among the elderly or compromised hosts. Subjects and Methods: This retrospective study aims to examine the clinical pictures, pathological findings, and the prognostic factor of IPA. We analyzed all patients with IPA who were admitted to our hospital from April 2006 to July 2011. Patients’ characteristics, treatment, clinical outcome, radiological findings, bacteria isolated, and comorbidities were evaluated. The comorbidities were evaluated by the Charlson comorbidity index (CCI). We compared the survival and non-survival groups to assess the prognostic factors of IPA. Results: A total of 33 patients were enrolled in this study, which included 14 males and 19 females. The mean age of the patients was 71.5 years (range 32-92 years). The most common underlying disease was spinal disease (16 of 33, 48.5%). Twenty-nine patients (87.9%) were cured and four patients (12.1%) died. While 12 patients (36.4%) were initially treated conservatively with antibiotics alone, percutaneous drainage was performed initially in 19 patients (57.6%). Two patients (6%) directly underwent exploratory surgery and open drainage. In terms of patients’ characteristics, there were no significant differences in either group. The score of CCI in non-survivors was higher than that in survivors (1.38 vs. 5.5, P < 0.001). Conclusions: The epidemiology of IPA is quite different from what it used to be. CCI appears to be useful in evaluating the patients’ prognosis with IPA.

Asai, Nobuhiro; Ohkuni, Yoshihiro; Yamazaki, Ikuo; Kawamura, Yasutaka; Kaneko, Norihiro; Aoshima, Masahiro



Intellectual Property and the Availability of Pharmaceuticals in Poor Countries  

Microsoft Academic Search

Abstract There continues,to be widespread,criticism of the extension,of patent rights on pharmaceuticals,in the developing world as required by World Trade Organization membership. This paper examines,arguments,in favor and against this strengthening,of worldwide patent protection. It emphasizes,that these new pharmaceutical,patents promise benefits and costs that differ with the characteristics of diseases. Some diseases primarily affect poor countries. For these diseases, patents will

Jean O. Lanjouw



2020 Focus briefs on the world's poor and hungry people  

Microsoft Academic Search

Contents: 1.The Changing Profile of Poverty in the World\\/Shaohua Chen and Martin Ravallion. 2.Characteristics and Causes of Severe Poverty and Hunger\\/Akhter U. Ahmed, Ruth Vargas Hill, Lisa C. Smith, and Tim Frankenberger. 3.The Poorest and Hungry: Looking Below the Line\\/Akhter U. Ahmed, Ruth Vargas Hill, and Doris M. Wiesmann. 4.Mapping Where the Poor Live\\/Todd Benson, Michael Epprecht, and Nicholas Minot



Poor people, poor places, and poor health: the mediating role of social networks and social capital.  


This paper explores the dynamics between poverty and exclusion; neighbourhood, and health and well being by considering the role of social networks and social capital in the social processes involved. It is based on qualitative research taking two deprived areas as exemplary case studies, and involving depth interviews with residents. Neighbourhood influences on networks and social capital were explored, network typologies developed reflecting structural and cultural aspects of individual's networks, and pathways implicated in health effects considered. The complexity of social capital is addressed. The role of three factors in influencing social networks and social capital are demonstrated: neighbourhood characteristics and perceptions; poverty and social exclusion, and social consciousness. Perceptions of inequality could be a source of social capital as well as demoralisation. Different network structures-dense and weak, homogeneous and heterogeneous- were involved in the creation of social capital and had implications for well being. Coping, enjoyment of life and hope are identified as benefits. Although participation in organisations was confirmed as beneficial, it is suggested that today's heterogeneous neighbourhoods also require regenerated local work opportunities to develop bridging ties necessary for the genesis of inclusive social capital and better health. Despite the capacity of social capital to buffer its harsher effects, the concept is not wholly adequate for explaining the deleterious effects of poverty on health and well being. PMID:11314847

Cattell, V



Expression and prognostic relevance of MUC1 in stage IB non-small cell lung cancer  

Microsoft Academic Search

The goal of this study was to evaluate the expression of MUC1 in stage IB non-small cell lung cancer (NSCLC) and its prognostic\\u000a significance. The expression of MUC1 in 178 NSCLC specimens was evaluated via immunohistochemistry. A reproducible semiquantitative\\u000a method which took both staining percentage and intensity into account was applied for immunohistochemical scoring, and receiver\\u000a operating characteristic curve analysis

Dongrong SituJian; Jian Wang; Yun Ma; Zhihua Zhu; Yi Hu; Hao Long; Tiehua Rong


Retrospective study of prognostic factors in non-Hodgkin lymphoma secondarily involving the central nervous system  

Microsoft Academic Search

The aim of this retrospective single-center study was to analyze the clinical characteristics and outcome of non-Hodgkin lymphoma\\u000a (NHL) patients with central nervous system (CNS) involvement and to identify prognostic factors for survival. We searched\\u000a our hospital records for NHL patients diagnosed with CNS involvement from 1982 to 2004, and 43 patients were identified. The\\u000a median age was 63 years

Kristoph Jahnke; Eckhard Thiel; Peter Martus; Stefan Schwartz; Agnieszka Korfel



Poor people's knowledge : helping poor people to earn from their knowledge  

Microsoft Academic Search

How can we help poor people to earn more from their knowledge rather than from their sweat and muscle? This paper draws lessons from projects intended to promote and protect the innovation, knowledge, and creative skills of poor people in poor countries, particularly to improve the earnings of poor people from such knowledge and skills. The international community has paid

J. Michael Finger



Prognostic Value of Promoter Hypermethylation of Retinoic Acid Receptor Beta (RARB) and CDKN2 (p16/MTS1) in Prostate Cancer  

PubMed Central

Objective The molecular mechanism of prostate cancer is poorly understood. The aim of the study was to investigate the prevalence and prognostic value of promoter hypermethylation of retinoic acid receptor beta (RARB) and p16 among benign prostatic hyperplasia (BPH) and prostate cancer patients. Methods In this case-control study, 63 patients were included in three groups; 21 with BPH as the control group, 21 with prostate cancer and good prognostic factors (based on prostate-specific antigen, Gleason score and stage) as good prognosis group, and 21 with prostate cancer and poor prognostic features as poor prognosis group. The prostate biopsy specimen of each individual was examined for hypermethylation of RARB and p16 promoters by methylation specific PCR (MSPCR). Results Seven (33.3%) patients with good prognosis and 15 (71.4%) patients with poor prognosis were positive for RARB methylation, which were significantly higher than controls (P<0.0001). p16 promoter methylation was shown in 19.0% and 47.6% patients with good and poor prognosis, respectively. The RARB and p16 promoter methylation in the poor prognosis group was significantly higher than that in the good prognosis group (P =0.02 for RARB and P<0.0001 for p16). Conclusion Hypermethylation of RARB and p16 promoters may predict prognosis in prostate cancer.

Ameri, Ahmad; Alidoosti, Asdollah; Hosseini, Seyed Yousef; Parvin, Mohammad; Emranpour, Mohammad Hasan; Taslimi, Farnaz; Salehi, Eisa; Fadavip, Pedram



Expression and prognostic value of transcription factor PROX1 in colorectal cancer  

PubMed Central

Background: PROX1 is a specific target of the ?-catenin/TCF pathway in the intestinal epithelium. It acts as a regulator of progression from a benign to a highly dysplastic phenotype in colorectal tumours. However, the clinical significance of PROX1 expression is not known. Methods: We studied the prognostic value of immunohistochemical expression of PROX1 in a series of 517 patients with colorectal cancer (CRC). Results: The majority of the tumour samples expressed PROX1 (91%, 471 out of 517). High PROX1 expression was associated with a poor grade of tumour differentiation (P<0.0001). In the subgroup of patients with colon cancer, high PROX1 expression was associated with unfavourable colorectal cancer-specific survival (CCSS) as compared with low PROX1 expression (CCSS 47% vs 62% P=0.045; RR 1.47). The association between high PROX1 and poor outcome was further strengthened in female colon cancer patients (CCSS 38% vs 63% P=0.007; RR 2.02). Nonetheless, in multivariate survival analysis PROX1 expression was not retained as an independent prognostic factor. Conclusion: High PROX1 expression is associated with a poor grade of tumour differentiation, and, in colon cancer patients, also with less favourable patient outcome. Our results strengthen the previous preclinical observations that PROX1 has a role in tumour progression in CRC.

Skog, M; Bono, P; Lundin, M; Lundin, J; Louhimo, J; Linder, N; Petrova, T V; Andersson, L C; Joensuu, H; Alitalo, K; Haglund, C H



Prognostic significance of disordered calcium metabolism in hormone-refractory prostate cancer patients with metastatic bone disease  

Microsoft Academic Search

Bone metabolic disruption that occurs in bone metastatic prostate cancer could lead to disturbances of calcium metabolism. The prognostic role of either hypocalcemia or hypercalcemia was assessed in a consecutive series of hormone-refractory bone metastatic prostate cancer patients. Serum calcium was measured in 192 patients. The presence of hypocalcemia and hypercalcemia was related with baseline biochemical and clinical characteristics and

M Tucci; A Mosca; G Lamanna; F Porpiglia; M Terzolo; F Vana; C Cracco; L Russo; G Gorzegno; M Tampellini; M Torta; G Reimondo; M Poggio; R M Scarpa; A Angeli; L Dogliotti; A Berruti



The prognostic value of morphometrical features and cellular DNA content in cis-platin treated late ovarian cancer patients  

Microsoft Academic Search

In 73 CAP-1 treated stage III and IV ovarian cancers, the prognostic significance of morphometric features and cellular DNA content has been evaluated in comparison with histologic type, grade of differentiation and a number of clinical characteristics. Borderline tumours were excluded from the study. Median follow-up was 44 months, median survival time 36 months. Single features associated with prognosis were

JPA Baak; NW Schipper; ECM Wisse-Brekelmans; T Ceelen; FT Bosman; H van Geuns; J Wils



Clinical Course of Early Onset Prostate Cancer with Special Reference to Family History as a Prognostic Factor  

Microsoft Academic Search

Objective: The aim of this study was to describe the clinical characteristics of early onset prostate cancer, with special reference to family history as a possible prognostic factor. Material and Methods: We identified all cases of prostate cancer diagnosed before the age of 51 in the Southern health care region in Sweden between 1958 and 1994. Clinical data were collected

Ola Bratt; Ulf Kristoffersson; Håkan Olsson; Rolf Lundgren



Expression of p53, Bcl2, VEGF, Ki67 and PCNA and Prognostic Significance in Hepatocellular Carcinoma  

Microsoft Academic Search

Background. Hepatocellular carcinoma is one of the most common malignant tumors that carry a poor prognosis. To improve the long-term outlook for HCC, an accurate prognosis is important. Aims. To study the immunohistochemical expressions of p53, Ki67, Bcl-2, VEGF and PCNA and their potential role as prognostic factors in patients with radical resection of hepatocellular carcinoma. Patients and methods. Forty-seven

Cezar Stroescu; Adrian Dragnea; Bogdan Ivanov; Catalin Pechianu; Vlad Herlea; Olivia Sgarbura; Andra Popescu; Irinel Popescu



P-cadherin expression as a prognostic biomarker in a 3992 case tissue microarray series of breast cancer  

Microsoft Academic Search

P-cadherin is a calcium-dependent cell–cell adhesion glycoprotein. P-cadherin expression is restricted to the myoepithelial cells in normal breast tissue, and aberrant staining has also been described in invasive tumors. Several small studies have reported P-cadherin as a marker of poor outcome in breast cancer patients but its prognostic significance in relation to other variables has not been established in a

Gulisa Turashvili; Steven E McKinney; Ozge Goktepe; Samuel C Leung; David G Huntsman; Karen A Gelmon; Gerrit Los; Paul A Rejto; Samuel A J R Aparicio



Prognostic value of weight change in chronic obstructive pulmonary disease: results from the Copenhagen City Heart Study  

Microsoft Academic Search

An association between low body mass index (BMI) and poor prognosis in patients with chronic obstructive pulmonary disease (COPD) has been found in a number of studies. The prevalence and prognostic importance of weight change in unselected subjects with COPD was examined. Subjects with COPD, defined as forced expiratory volume in one second\\/forced vital capacityv0.7 in the Copenhagen City Heart

E. Prescott; T. Almdal; K. L. Mikkelsenz; C. L. Tofteng; J. Vestbo; P. Lange



BEAM chemotherapy followed by autologous stem cell support in lymphoma patients: analysis of efficacy, toxicity and prognostic factors  

Microsoft Academic Search

In the present paper, we evaluate tolerability, outcome and prognostic factors in patients with poor prognosis non-Hodgkin’s lymphoma (NHL) and Hodgkin’s disease (HD) when uniformly treated with BCNU, etoposide, cytarabine and melphalan (BEAM) and autologous stem cell transplant (ASCT). One hundred and forty-eight patients with NHL (n = 112) or HD (n = 36) received BEAM followed by infusion of

V Rubio; J Rifon; I Heras; R García-Sanz; L Vázquez; B Vidriales; MCdel Cañizo; M Corral; M Gonzalez; A León; E Jean-Paul; E Rocha; JM Moraleda; JFSan Miguel



Prognostic significance of platelet recovery pattern after allogeneic HLA-identical sibling transplantation and its association with severe acute GVHD  

Microsoft Academic Search

Thrombocytopenia (TP) is a frequent complication after allogeneic stem cell transplantation (SCT) and regarded as a poor prognostic factor when assessed beyond day 100. However, little is known about the clinical significance of the platelet recovery pattern before chronic graft-versus-host disease (GVHD) develops. Eighty-five patients undergoing HLA-identical sibling SCT were stratified according to their platelet recovery pattern between day +30

D H Kim; S K Sohn; S B Jeon; J H Baek; J G Kim; N Y Lee; J S Suh; K B Lee; I H Shin



Time Estimation in Good and Poor Sleepers  

Microsoft Academic Search

Time estimation was examined in 148 older good and poor sleepers in analogue and naturalistic sleep settings. On analogue\\u000a tasks, both “empty” time and time listening to an audiobook were overestimated by both good and poor sleepers. There were\\u000a no differences between groups. “Empty” time was experienced as “dragging.” In the sleep setting, most poor sleepers underestimated\\u000a nocturnal sleep and

Catherine S. Fichten; Laura Creti; Rhonda Amsel; Sally Bailes; Eva Libman



Activated leukocyte cell adhesion molecule in breast cancer: prognostic indicator  

PubMed Central

Introduction Activated leukocyte cell adhesion molecule (ALCAM) (CD166) is an immunoglobulin molecule that has been implicated in cell migration. The present study examined the expression of ALCAM in human breast cancer and assessed its prognostic value. Methods The immunohistochemical distribution and location of ALCAM was assessed in normal breast tissue and carcinoma. The levels of ALCAM transcripts in frozen tissue (normal breast, n = 32; breast cancer, n = 120) were determined using real-time quantitative PCR. The results were then analyzed in relation to clinical data including the tumor type, the grade, the nodal involvement, distant metastases, the tumor, node, metastasis (TNM) stage, the Nottingham Prognostic Index (NPI), and survival over a 6-year follow-up period. Results Immunohistochemical staining on tissue sections in ducts/acini in normal breast and in breast carcinoma was ALCAM-positive. Differences in the number of ALCAM transcripts were found in different types of breast cancer. The level of ALCAM transcripts was lower (P = 0.05) in tumors from patients who had metastases to regional lymph nodes compared with those patients without, in higher grade tumors compared with Grade 1 tumors (P < 0.01), and in TNM Stage 3 tumors compared with TNM Stage 1 tumors (P < 0.01). Tumors from patients with poor prognosis (with NPI > 5.4) had significantly lower levels (P = 0.014) of ALCAM transcripts compared with patients with good prognosis (with NPI < 3.4), and tumors from patients with local recurrence had significantly lower levels than those patients without local recurrence or metastases (P = 0.04). Notably, tumors from patients who died of breast cancer had significantly lower levels of ALCAM transcripts (P = 0.0041) than those with primary tumors but no metastatic disease or local recurrence. Patients with low levels of ALCAM transcripts had significantly (P = 0.009) more incidents (metastasis, recurrence, death) compared with patients with primary breast tumors with high levels of ALCAM transcripts. Conclusions In the present panel of breast cancer specimens, decreased levels of ALCAM correlated with the nodal involvement, the grade, the TNM stage, the NPI, and the clinical outcome (local recurrence and death). The data suggest that decreased ALCAM expression is of clinical significance in breast cancer, and that reduced expression indicates a more aggressive phenotype and poor prognosis.

King, Judy A; Ofori-Acquah, Solomon F; Stevens, Troy; Al-Mehdi, Abu-Bakr; Fodstad, Oystein; Jiang, Wen G



Elevated ALCAM shedding in colorectal cancer correlates with poor patient outcome.  


Molecular biomarkers of cancer are needed to assist histologic staging in the selection of treatment, outcome risk stratification, and patient prognosis. This is particularly important for patients with early-stage disease. We show that shedding of the extracellular domain of activated leukocyte cell adhesion molecule (ALCAM) is prognostic for outcome in patients with colorectal cancer (CRC). Previous reports on the prognostic value of ALCAM expression in CRC have been contradictory and inconclusive. This study clarifies the prognostic value of ALCAM by visualizing ectodomain shedding using a dual stain that detects both the extracellular and the intracellular domains in formalin-fixed tissue. Using this novel assay, 105 patients with primary CRCs and 12 normal mucosa samples were evaluated. ALCAM shedding, defined as detection of the intracellular domain in the absence of the corresponding extracellular domain, was significantly elevated in patients with CRC and correlated with reduced survival. Conversely, retention of intact ALCAM was associated with improved survival, thereby confirming that ALCAM shedding is associated with poor patient outcome. Importantly, analysis of patients with stage II CRC showed that disease-specific survival is significantly reduced for patients with elevated ALCAM shedding (P = 0.01; HR, 3.0), suggesting that ALCAM shedding can identify patients with early-stage disease at risk of rapid progression. PMID:23539446

Hansen, Amanda G; Freeman, Tanner J; Arnold, Shanna A; Starchenko, Alina; Jones-Paris, Celestial R; Gilger, Michael A; Washington, Mary K; Fan, Kang-Hsien; Shyr, Yu; Beauchamp, Robert D; Zijlstra, Andries



RON (MST1R) is a novel prognostic marker and therapeutic target for gastroesophageal adenocarcinoma  

PubMed Central

RON (MST1R) is one of two members of the MET receptor tyrosine kinase family, along with parent receptor MET. RON has a putative role in several cancers, but its expression and function is poorly characterized in gastroesophageal adenocarcinoma. A recognized functional role of MET tyrosine kinase in gastroesophageal cancer has led to early phase clinical trials using MET inhibitors, with unimpressive results. Therefore, the role of RON in gastroesophageal cancer, as well as its role in cooperative signaling with MET and as a mechanism of resistance to MET inhibition, was studied in gastroesophageal tissues and cell lines. By IHC, RON was highly overexpressed in 74% of gastroesophageal samples (n = 94) and overexpression was prognostic of poor survival (p = 0.008); RON and MET co-expression occurred in 43% of samples and was prognostic of worst survival (p = 0.03). High MST1R gene copy number by quantitative polymerase chain reaction and confirmed by fluorescence in situ hybridization and/or array comparative genomic hybridization, was seen in 35.5% (16/45) of cases. High MST1R gene copy number correlated with poor survival (p = 0.01), and was associated with high MET and ERBB2 gene copy number. a novel somatic MST1R juxtamembrane mutation R1018G was found in 11% of samples. RON signaling was functional in cell lines, activating downstream effector STAT3, and resulted in increased viability over controls. RON and MET co-stimulation assays led to enhanced malignant phenotypes over stimulation of either receptor alone. Growth inhibition as evidenced by viability and apoptosis assays was optimal using novel blocking monoclonal antibodies to both ROn and MET, versus either alone. SU11274, a classic MET small molecule tyrosine kinase inhibitor, blocked signaling of both receptors and proved synergistic when combined with STAT3 inhibition (combination index <1). These preclinical studies define RON as an important novel prognostic marker and therapeutic target for gastroesophageal cancer warranting further investigation.

Catenacci, Daniel VT; Cervantes, Gustavo; Yala, Soheil; Nelson, Erik A; El-Hashani, Essam; Kanteti, Rajani; El Dinali, Mohamed; Hasina, Rifat; Bragelmann, Johannes; Seiwert, Tanguy; Sanicola, Michele; Henderson, Les; Grushko, Tatyana A; Olopade, Olufunmilayo; Karrison, Theodore; Bang, Yung-Jue; Ho Kim, Woo; Tretiakova, Maria; Vokes, Everett; Frank, David A; Kindler, Hedy L; Huet, Heather



Prognostic factors influencing the outcome in pneumocystis carinii pneumonia in patients with AIDS.  

PubMed Central

BACKGROUND--Studies attempting to identify the prognostic factors that influence the outcome of Pneumocystis carinii pneumonia (PCP) in patients with AIDS using a multivariate analysis are few. In order to identify those prognostic factors amenable to medical intervention, univariate and multivariate analyses were performed on 102 patients with AIDS suffering a first episode of PCP. METHODS--One hundred and two consecutive patients with AIDS (51% drug abusers, 45% homosexuals, and 4% with other HIV risk factors) admitted to our institution between 1986 and 1989 whose respiratory infection was diagnosed by bronchoalveolar lavage were studied prospectively. RESULTS--The overall mortality was 28%, rising to 79% in those patients who required mechanical ventilation. According to univariate analysis the following variables were related to a poor prognosis: age > 35 years; risk factor for HIV infection other than drug abuse; and AIDS diagnosis confirmed before 1988; PaO2 < 8 kPa at admission; severe acute respiratory failure on admission (PaO2/FIO2 < 20 kPa); mechanical ventilation; antibiotic therapy for PCP other than trimethoprim-sulphamethoxazole; multiple microbial pulmonary infection; serum lactate dehydrogenase (LDH) > 22.5 mukat/l on admission; serum albumin level < 30 g/l. Multivariate analysis showed that only mechanical ventilation was independently associated with a poor outcome. CONCLUSIONS--The mortality of AIDS patients presenting with a first episode of PCP before 1990 was high (28%). The main prognostic factor associated with poor outcome was the requirement for mechanical ventilation due to severe acute respiratory failure.

Fernandez, P; Torres, A; Miro, J M; Vieigas, C; Mallolas, J; Zamora, L; Gatell, J M; Valls, M E; Riquelme, R; Rodriguez-Roisin, R



The Strengths of Poor Families. Research Brief. Publication #2009-26  

ERIC Educational Resources Information Center

In the minds of many people, poor families equal problem families. Indeed, that perception is not surprising, giving compelling evidence of the harsh effects that poverty can have on family life and child well-being. However, far less attention has been paid to the strengths that many poor families have and the characteristics that they may share…

Valladares, Sherylls; Moore, Kristin Anderson



Do Microbiological Factors Account for Poor Pregnancy Outcome among Unmarried Pregnant Women in Poland?  

Microsoft Academic Search

Objective: Being unmarried is a well-known risk factor for poor pregnancy outcome such as preterm delivery and intrauterine growth restriction. The aim of this prospective study was to assess the prevalence and risk of bacterial vaginosis (BV) and selected bacteria isolated from the lower genital tract and to determine the socioeconomic and microbiological characteristics that might be responsible for poor

Wojciech Hanke



[Prognostic value of gene expression profiling using cDNA arrays in lymphomas].  


Lymphomas are the most frequent haematological malignancies in France. Their histoclinical heterogeneity reflects their complex and combinatorial nature which remains poorly elucidated at the molecular level. Today, DNA arrays allow to tackle this diversity by measuring the mRNA expression level of thousands of genes simultaneously in one sample. Recent publications show the potential of DNA arrays to improve the prognostic classification of diffuse large B cell lymphomas and of Hodgkin's lymphoma, by identifying new tumour classes unrecognised by classical factors. PMID:12206978

Bertucci, François; Salas, Sébastien; Nasser, Valéry; Houlgatte, Rémi; Birnbaum, Daniel; Xerri, Luc


Predictors of poor outcome in chronic dialysis patients: The Netherlands cooperative study on the adequacy of dialysis  

Microsoft Academic Search

In a prospective cohort study, we constructed a composite index of poor outcome that incorporates survival, morbidity, and quality of life (QL). We identified baseline patient and treatment characteristics that predicted poor outcome 1 year after the start of chronic dialysis. Outcome was classified as poor if a patient had died or if at least two of the following criteria

Maruschka P. Merkus; Kitty J. Jager; Friedo W. Dekker; Rob J. de Haan; Els W. Boeschoten; Raymond T. Krediet



High expression of high mobility group box 1 (hmgb1) predicts poor prognosis for hepatocellular carcinoma after curative hepatectomy  

PubMed Central

Background High mobility group box 1(HMGB1) overexpression has been reported in a variety of human cancers. However, the role of HMGB1 in hepatocellular carcinoma (HCC) remains unclear. The aim of present study was to analyze HMGB1 protein expression in tumor, para-tumor and normal tissue and to assess its prognostic significance for HCC after curative hepatectomy. Methods The levels of HMGB1 mRNA and protein in tumor, para-tumor and normal tissue were evaluated in 11 HCC cases by Reverse Transcription-polymerase chain reaction (RT-PCR) and Western blot. Additionally, HMGB1 protein expression in 161 HCC was analyzed by immunohistochemistry and correlated with clinicopathological characteristics and survivals. Student’s t-test, spearman’s rank correlation, Kaplan-Meier plots and Cox proportional hazards regression model were used to analyze the data. Results By RT-PCR and Western blot, the levels of HMGB1 mRNA and protein were significantly higher in HCC, compared to that in para-tumor (p?prognostic factor for both overall (p?=?0.009, HR?=?1.834, 95%CI: 1.167-2.881) and disease-free survival (p?=?0.018, HR?=?1.622, 95%CI: 1.088-2.419), along with tumor size. Subgroup analysis revealed that high expression of HMGB1 predicted poorer overall survival only for tumor >5?cm (p?=?0.031), but not for tumor ?5?cm (p?=?0.101). Conclusions HMGB1 protein might contribute to the malignant progression of HCC, high expression of HMGB1 predicts poor prognosis for patients with HCC after curative hepatectomy, especially for patients with tumor >5?cm.



Distinct distribution and prognostic significance of molecular subtypes of breast cancer in Chinese women: a population-based cohort study  

Microsoft Academic Search

Background  Molecular classification of breast cancer is an important prognostic factor. The distribution of molecular subtypes of breast\\u000a cancer and their prognostic value has not been well documented in Asians.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 2,791 breast cancer patients recruited for a population-based cohort study were evaluated for molecular subtypes\\u000a of breast cancer by immunohistochemical assays. Data on clinicopathological characteristics were confirmed by

Yinghao Su; Ying Zheng; Wei Zheng; Kai Gu; Zhi Chen; Guoliang Li; Qiuyin Cai; Wei Lu; Xiao Ou Shu



Low expression of TFPI-2 associated with poor survival outcome in patients with breast cancer  

PubMed Central

Background The purpose of this study is to evaluate the prognostic value of TFPI-2 expression in breast cancer patients through examining the correlation between TFPI-2 expression and breast cancer clinicopathologic features. Methods Immunohistochemical staining combined with digital image analysis was used to quantify the expression of TFPI-2 protein in breast tumor tissues. For evaluation of the prognostic value of TFPI-2 expression to each clinicopathologic factor, Kaplan-Meier method and COX’s Proportional Hazard Model were employed. Results TFPI-2 expression was significantly correlated with tumor size, lymph node metastasis, histologic grade, clinical stage, and vessel invasion. More importantly, TFPI-2 expression was also associated with disease-free survival (DFS) of breast cancer patients. We found that patients with high TFPI-2 expression had longer DFS compared with those with low or negative expression of TFPI-2 (P <0.05, log-rank test). Cox’s regression analysis indicated that TFPI-2 expression, histologic grade, and vessel invasion might be significant prognostic factors for DFS, while TFPI-2 expression and histologic grade were the most significant independent predictors for tumor recurrence. Compared with the group with low/high TFPI-2 expression, the TFPI-2 negative group was more likely to have tumor relapse. The hazard ratio of DFS is 0.316 (P <0.01). Conclusions Low or negative expression of TFPI-2 is associated with breast cancer progression, recurrence and poor survival outcome after breast cancer surgery. TFPI-2 expression in breast tumors is a potential prognostic tool for breast cancer patients.



The Economic Lives of the Poor  

Microsoft Academic Search

The 1990 World Development Report from the World Bank defined the “extremely poor” people of the world as those who are currently living on no more than $1 per day per person. But how actually does one live on less than $1 per day? This essay is about the economic lives of the extremely poor: the choices they face, the

Abhijit V. Banerjee; Esther Duflo



Making Services Work for Poor People  

Microsoft Academic Search

The weak link between public spending in health and education, and health and education outcomes can be partially explained by the fact that the delivery of services that are critical to human development -- health, education, water and sanitation -- are widely failing poor people. The money is often spent on private goods or on the non-poor; it often fails

Shantayanan Devarajan; Ritva Reinikka



Poor Rural Children Attract Close Study  

ERIC Educational Resources Information Center

|Growing up poor in isolated rural areas and small towns is qualitatively different from growing up poor in the city. Yet most of what experts know about the effects of poverty on children's development comes from studies conducted in big cities. Now, an ambitious project run by universities in Pennsylvania and North Carolina is putting what some…

Viadero, Debra



Dichotic Listening in Good and Poor Readers.  

ERIC Educational Resources Information Center

|Results of the study involving 15 good and 15 poor readers (10-13 years old) revealed that poor readers did not demonstrate atypical laterality or phonetic processing effects in dichotic consonant vowel tasks. Results support findings that reading disabled children exhibit a deficit in processing two items on dichotic tasks. (Author/CL)|

Dermody, Phillip; And Others



Pro-Poor Growth: A Primer  

Microsoft Academic Search

These days it seems that almost everyone in the development community is talking about ?pro-poor growth.? What exactly is it, and how can we measure it? Is ordinary economic growth always ?pro-poor growth? or is that some special kind of growth? And if it is something special, what makes it happen? Ravallion first reviews alternative approaches to defining and measuring

Martin Ravallion



Correcting Poor Posture without Awareness or Willpower  

ERIC Educational Resources Information Center

|In this article, a new technique for correcting poor posture is presented. Rather than intentionally increasing awareness or mobilizing willpower to correct posture, this approach offers a game using randomly drawn cards with easy daily assignments. A case using the technique is presented to emphasize the subjective experience of living with poor

Wernik, Uri



Prognostic and Predictive Markers in Colorectal Cancer  

Microsoft Academic Search

Prognostic and predictive biomarkers have revolutionized medicine by allowing individualized treatment decisions. Most notably\\u000a in oncology, where treatment can be associated with significant toxicities and often unpredictable outcomes, there is a need\\u000a to isolate patients that are likely to benefit from an intervention. In colorectal cancer, there are many markers being investigated\\u000a but only a few that have sufficient evidence

Sangeetha Reddy; Maxwell Vergo; Al B. Benson


Myelodysplastic syndrome: classification and prognostic systems  

Microsoft Academic Search

Myelodysplastic syndromes (MDS) are acquired clonal disorders of hematopoiesis, that are characterized most frequently by\\u000a normocellular or hypercellular bone marrow specimens, and maturation that is morphologically and functionally dysplastic.\\u000a MDS constitute a complex hematological problem: differences in disease presentation, progression and outcome have made it\\u000a necessary to use classification systems to improve diagnosis, prognostication and treatment selection. On the basis

Rosangela Invernizzi; Agnese Filocco



The value of prognostic indices for pneumonia  

Microsoft Academic Search

One of the most important decisions in the management of community-acquired pneumonia is deciding the care site, which affects\\u000a morbidity, mortality, and costs. Clinical judgment alone is difficult and imprecise. The Pneumonia Severity Index score and\\u000a the CURB-65 (confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older) score are validated prognostic\\u000a indices to predict mortality, and

Jennie Johnstone; Sumit R. Majumdar; Thomas J. Marrie



Prognostic factors in juvenile idiopathic arthritis  

Microsoft Academic Search

Prognostic factors in juvenile arthritis are related to many variables that must be evaluated according to the different subtypes.\\u000a The International League of Associations of Rheumatologists (ILAR) recently proposed six different categories referred to\\u000a as the Durban criteria, under the eponym of juvenile idiopathic arthritis (JIA). The aim of this classification was to define\\u000a homogeneous groups according to their clinical

Anne-Marie Prieur; Gaëlle Chèdeville



Prognostic and Survival Factors in Myxofibrosarcomas  

PubMed Central

Aim. Our study aimed to determine prognostic factors for survival and recurrence in myxofibrosarcomas based on the experience of a single institution. Methods. Patients who had been diagnosed with a myxofibrosarcoma were identified from our database. Survival and recurrence were evaluated with Kaplan Meier survival curves for univariate and cox regression for multivariate analysis. Results. 174 patients with a diagnosis of myxofibrosarcoma were identified. Two patients were excluded due to incomplete information, leaving 172 patients with a mean age of 67 years. Surgery was undertaken in all but 6 patients. Five-year survival was better for myxofibrosarcomas when compared to other soft tissue sarcomas (63% versus 57%). Size, grade of tumour, age, and metastases were all found to be prognostic factors. Local recurrence occurred in 29 patients (17%) with an overall risk of 15% at 5 years. Previous inadvertent excision significantly raised this risk to 45%. Wide surgical margins and depth of tumour, however, had no impact on recurrence. Conclusion. Factors previously identified as prognostic did not demonstrate such a relationship in our study, highlighting the unpredictable nature of myxofibrosarcomas. Future treatment may lie in developing an understanding molecular basis of the tumour and directing therapies accordingly.

Dewan, Varun; Darbyshire, Anna; Sumathi, Vaiyapuri; Jeys, Lee; Grimer, Robert



Multidimensional prognostic index in the elderly with hip or neck femur fracture  

PubMed Central

Hip and neck femur fracture surgery was associated with high post-operative mortality and poor functional results. The decision-making process with regards to the elderly with hip or neck femur fractures was of great importance, requiring consideration of ethical, medico legal and economic factors in addition to the purely medical ones. An important component in the decision-making process was the precise knowledge of the expected mortality. We considered here several articles from 1 January 2002 to 31 August 2010 that identified the possible scoring system to predict mortality in the elderly undergoing hip or neck femur fracture surgery. We found seven studies which included a total of 12,177 patients that were assigned to hip/neck femur fracture surgery. Each study identified the possible scoring system to predict mortality in the elderly undergoing hip/neck femur fracture surgery. By reviewing the literature available, it was shown that there were more multidimensional prognostic indexes in the elderly after hospitalization than multidimensional prognostic indexes with hip or neck femur fracture which could be used as a simple point scoring system at the bedside to predict mortality in the elderly undergoing hip or neck femur fracture surgery. Although, all the prognostic indexes searched worked well for a general population, but they were of limited validity in the specific, relatively homogeneous population of hip/neck femur fracture patients.

Vitale, Elsa; Notarnicola, Angela; Moretti, Lorenzo; Antonio, Esposito; Pesce, Vito; Moretti, Biagio



Relationship and prognostic significance of SPARC and VEGF protein expression in colon cancer  

PubMed Central

Background SPARC (secreted protein, acidic and rich in cysteine) is closely related with the progress, invasion and metastasis of malignant tumor and angiogenesis. Methods Using human colon adenocarcinoma tissues (hereinafter referred to as colon cancer) and their corresponding non-diseased colon from 114 patients' biopsies, the expression of SPARC and vascular endothelial growth factor (VEGF) were investigated by immunohistochemistry staining to assessment the relationship between SPARC and VEGF, as well as their prognostic significance in patients. Evaluation of VEGF expression level with the same tissues was used to establish the antigenic profiles, and the marker of CD34 staining was used as an indicator of microvessel density (MVD). Results SPARC expression was mainly in the stromal cells surrounding the colon cancer, and was significant difference in those tissues with the lymph node metastasis and differentiation degree of tumor. Expression of SPARC was significantly correlated with the expression of VEGF and MVD in colon cancer tissues. Patients with low or absence expressing SPARC had significantly worse overall survival and disease-free survival in a Single Factor Analysis; Cox Regression Analysis, SPARC emerged as an overall survival and disease-free survival independent prognostic factor for colon cancer. Conclusion The low expression or absence of stromal SPARC was an independent prognostic factor for poor prognosis of colon cancer. SPARC maybe involved in the regulation of anti-angiogenesis by which it may serve as a novel target for colon cancer treatment as well as a novel distinctive marker.



Prognostic significance of flow cytometric DNA analysis in patients with malignant pleural mesothelioma.  


Malignant pleural mesothelioma (MPM) due to environmental exposure to asbestos and erionite is a relatively common cancer in Turkey. In this study, we investigated the value of flow cytometric (FCM) DNA analysis and other prognostic factors such as age and etiologic factor in the patients with MPM, treated with surgery+/-combination chemotherapy+/-radiotherapy. A total of 40 patients with a median age of 50 (range 30-68) were included in the study. Twenty-nine patients had asbestos exposure in etiology, while 11 had fibrous zeolite (erionite). Paraffin-embedded tumor specimens were studied by FCM for DNA analysis. Twelve patients (30%) had aneuploid tumors and 28 (70%) had diploid ones. Mean S-phase fraction (SPF; %) was 9.1+/-1.1 and proliferation index (PI, SPF+G2/M phase; %) was 11.3+/-0.9. While the median overall survival (OS) was 10+/-2 months (6-14; 95% CI), 1-year survival rate was 45.2%. Only PI was found to be statistically significant for OS in univariate analysis (P=0.013). PI was also found to be an independent prognostic factor for all patients (P=0.035). Aneuploidy was significantly higher in erionite group compared with asbestos group. Male predominance and poor survival were also prominent in erionite group, though not statistically significant. In conclusion, PI is an independent prognostic factor for patients with MPM and the biologic features of the disease may show differences with respect to different etiologies. PMID:11551405

Emri, S; Akbulut, H; Zorlu, F; Dinçol, D; Akay, H; Güngen, Y; Içli, F


Survival and prognostic factors in Malaysian acute myeloid leukemia patients after allogeneic haematopoietic stem cell transplantation.  


Studies of survival outcomes in acute myeloid leukemia (AML) patients treated with allogeneic haematopoietic stem cell transplantation (HSCT) are essential for planning patient care. The objectives of the present study were to determine overall survival (OS) and disease-free survival (DFS) in AML patients treated with allogeneic HSCT, and to identify prognostic factors associated with poor outcome. This study was conducted retrospectively, using data from the Blood and Bone Marrow Transplant, National Transplant Registry, Malaysia. All cases of AML treated with allogeneic HSCT registered at the registry between 1st January 1987 and 31st December 2010 were included in the study. A total of 300 patients were included for final analysis. The Kaplan-Meier method and Cox proportional hazard regression were used for statistical analysis. The overall 10-year OS and DFS for Malaysian AML patients after allogeneic HSCT were 63 and 67 %, respectively. Donor gender, marrow status, and conditioning intensity were identified as important prognostic factors for overall survival, whereas the significant prognostic factors for disease-free survival were ethnic group, donor gender, marrow status, and conditioning intensity. In conclusion, the survival outcomes for Malaysian AML patients treated with allogeneic HSCT were good, and this treatment should be considered the standard therapeutic approach for suitable candidates. PMID:23719676

Mangantig, Ernest; Naing, Nyi Nyi; Norsa'adah, Bachok; Azlan, Husin



Prognostic significance of cyclooxygenase-2 in osteosarcoma: a meta-analysis.  


Published studies researching the prognostic significance of cyclooxygenase-2 (COX-2) expression in patients with osteosarcoma are inconclusive and heterogeneous. We conducted a meta-analysis to assess its prognostic value more precisely. The pooled odds ratios (ORs) or hazard ratios (HRs) with corresponding 95 % confidence intervals (CIs) were calculated to evaluate the effects. Fourteen studies with 735 osteosarcoma patients were included to estimate the relationship between COX-2 and metastasis of tumor, clinical stage, and 3-year overall survival. High expressions of COX-2 predicted neoplasm metastasis (OR?=?1.891, 95 % CI 1.276-2.803, P?=?0.002), advanced clinical stage (OR?=?1.801, 95 % CI 1.257-2.581, P?=?0.001). In addition, high COX-2 expression tended to be associated with a poor 3-year survival (HR?=?1.741, 95 % CI 0.762-3.979, P?=?0.188), but the difference was not significant. Therefore, this meta-analysis demonstrated that high COX-2 expression might be an unfavorable prognostic effect in osteosarcoma. PMID:23857285

Jiao, Guangjun; Ren, Tingting; Lu, Qunshan; Sun, Yifeng; Lou, Zhiyuan; Peng, Xianbo; Liang, Weimin; Guo, Wei



A structured approach to neurologic prognostication in clinical cardiac arrest trials  

PubMed Central

Brain injury is the dominant cause of death for cardiac arrest patients who are admitted to an intensive care unit, and the majority of patients die after withdrawal of life sustaining therapy (WLST) based on a presumed poor neurologic outcome. Mild induced hypothermia was found to decrease the reliability of several methods for neurological prognostication. Algorithms for prediction of outcome, that were developed before the introduction of mild hypothermia after cardiac arrest, may have affected the results of studies with hypothermia-treated patients. In previous trials on neuroprotection after cardiac arrest, including the pivotal hypothermia trials, the methods for prognostication and the reasons for WLST were not reported and may have had an effect on outcome. In the Target Temperature Management trial, in which 950 cardiac arrest patients have been randomized to treatment at 33°C or 36°C, neuroprognostication and WLST-decisions are strictly protocolized and registered. Prognostication is delayed to at least 72 hours after the end of the intervention period, thus a minimum of 4.5 days after the cardiac arrest, and is based on multiple parameters to account for the possible effects of hypothermia.



Decreased Muc5AC expression is associated with poor prognosis in gastric cancer.  


Mucins reportedly play numerous key roles in carcinogenesis, including in tumor invasion, regulation of differentiation and tumor cell proliferation. We investigated the effect of Muc5AC, a secreted mucin, on the invasiveness/migratory capability of gastric cancer cells and the prognostic significance of Muc5AC in gastric cancer patients. The clinicopathological and prognostic significance of Muc5AC expression was validated using immunohistochemical analysis in 412 gastric cancer patients. Differential gene expression was investigated using complementary DNA microarray analysis of 48 fresh tumor tissue samples. Silencing of Muc5AC by using a small hairpin RNA-containing lentivirus increased the invasion and migration of SNU216 and AGS cells as well as Akt phosphorylation and the expression of vascular endothelial growth factor and matrix metalloproteinase-7, which were blocked by inhibitors of the phosphatidylinositol 3-kinase/Akt pathway. Loss of Muc5AC expression was significantly associated with tumor progression (advanced T stage; p = 0.004), lymph node metastases (p = 0.001), lymphovascular invasion (p < 0.0001), and increased tumor size (p = 0.027). Lower MUC5AC expression was identified as an independent poor prognostic factor in diffuse-type gastric cancer by using the Cox regression proportional hazard model (hazard ratio, 2.39; p = 0.043). Complementary DNA microarray analysis revealed 86 differentially expressed genes, including genes related to metastasis and invasion, in gastric cancer tissues with high (?25%) and low (<25%) Muc5AC expression levels. Low Muc5AC expression increased the invasion and migration of gastric cancer cells and could be a useful biomarker of poor prognosis in gastric cancer. PMID:23801416

Kim, Sung Mi; Kwon, Chae Hwa; Shin, Nari; Park, Do Youn; Moon, Hyun Jung; Kim, Gwang Ha; Jeon, Tae Yong



Electrocardiographic changes and their prognostic significance in subarachnoid haemorrhage  

PubMed Central

In a study on the prognostic significance of catecholamine-linked ECG changes in 40 cases of subarachnoid haemorrhage, there were 16 men of mean age 41 years (range 13-56) and 24 women of mean age 42 years (range 11-65). There were six deaths, and five of these patients had consistently abnormal ECGs. Analysis of the abnormal components of ECGs revealed that the presence of either a pathological Q wave or a raised S-T segment indicated a poor prognosis. The two patients with pathological Q waves both died, and the three patients with raised S-T segments all developed cerebral arterial spasm, one of whom died. A high incidence of peaked P waves, short P-R intervals, a long Q-Tc, and tall U waves occurred in the ECGs of six patients who died, the 15 patients with cerebral arterial spasm, and the seven patients who were later to develop cerebral arterial spasm. Three of the latter eventually died, in contrast with the single death in the 22 patients who did not develop cerebral arterial spasm and had a low incidence of P wave peaking, short P-R intervals, a long Q-Tc, and tall U waves. Various combinations of these four ECG changes, in addition to peaking of the T wave, indicated a bad prognosis irrespective of the type of treatment. The criteria for prognosis on the role of catecholamines in causing the ECG abnormalities are discussed.

Cruickshank, J. M.; Neil-Dwyer, G.; Brice, J.



Outcome and Prognostic Factors of Radiation Therapy for Medulloblastoma  

SciTech Connect

Purpose: To investigate treatment outcome and prognostic factors after radiation therapy in patients with medulloblastomas (MB). Methods and Materials: Sixty-six patients with histologically confirmed MB were treated at University Hospital of Heidelberg between 1985 and 2009. Forty-two patients (64%) were pediatric ({<=}18 years), and 24 patients (36%) were adults. Tumor resection was performed in all patients and was complete in 47%. All patients underwent postoperative craniospinal irradiation (CSI) delivering a median craniospinal dose of 35.5 Gy with additional boosts to the posterior fossa up to 54.0 Gy. Forty-seven patients received chemotherapy, including 21 in whom chemotherapy was administered before CSI. Statistical analysis was performed using the log-rank test and the Kaplan-Meier method. Results: Median follow-up was 93 months. Overall survival (OS) and local and distant progression-free survival (LPFS and DPFS) were 73%, 62%, and 77% at 60 months. Both local and distant recurrence predisposed for significantly reduced OS. Macroscopic complete tumor resection, desmoplastic histology and early initiation of postoperative radiation therapy within 28 days were associated with improved outcome. The addition of chemotherapy did not improve survival rates. Toxicity was moderate. Conclusions: Complete resection of MB followed by CSI yields long survival rates in both children and adults. Delayed initiation of CSI is associated with poor outcome. Desmoplastic histology is associated with improved survival. The role of chemotherapy, especially in the adult population, must be further investigated in clinical studies.

Rieken, Stefan, E-mail: [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Mohr, Angela; Habermehl, Daniel; Welzel, Thomas; Lindel, Katja [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Witt, Olaf; Kulozik, Andreas E. [Department of Pediatric Oncology, Hematology, Immunology, and Pneumatology, University of Heidelberg, Heidelberg (Germany); Wick, Wolfgang [Department of Neurooncology, University of Heidelberg, Heidelberg (Germany); Debus, Juergen; Combs, Stephanie E. [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)



The floating knee: epidemiology, prognostic indicators & outcome following surgical management  

PubMed Central

Background Floating Knee injuries are complex injuries. The type of fractures, soft tissue and associated injuries make this a challenging problem to manage. We present the outcome of these injuries after surgical management. Methods 29 patients with floating knee injuries were managed over a 3 year period. This was a prospective study were both fractures of the floating knee injury were surgically fixed using different modalities. The associated injuries were managed appropriately. Assessment of the end result was done by the Karlstrom criteria after bony union. Results The mechanism of injury was road traffic accident in 27/29 patients. There were 38 associated injuries. 20/29 patients had intramedullary nailing for both fractures. The complications were knee stiffness, foot drop, delayed union of tibia and superficial infection. The bony union time ranged from 15 – 22.5 weeks for femur fractures and 17 – 28 weeks for the tibia. According to the Karlstrom criteria the end results were Excellent – 15, Good – 11, Acceptable – 1 and Poor – 3. Conclusion The associated injuries and the type of fracture (open, intra-articular, comminution) are prognostic indicators in the Floating knee. Appropriate management of the associated injuries, intramedullary nailing of both the fractures and post operative rehabilitation are necessary for good final outcome.

Rethnam, Ulfin; Yesupalan, Rajam S; Nair, Rajagopalan



High anaplastic lymphoma kinase immunohistochemical staining in neuroblastoma and ganglioneuroblastoma is an independent predictor of poor outcome.  


Anaplastic lymphoma kinase (ALK) mutations occur in 3% to 11% of neuroblastoma (NBL) cases and are associated with high ALK levels. However, high ALK levels appear to be a mutation-independent hallmark of NBL. Evidence about the prognostic relevance of ALK mutations and ALK tumor positivity in patients with NBL has been inconclusive. In this study, we investigated the prognostic relevance of ALK positivity by IHC and ALK mutation status by PCR sequencing in 71 NBL, 12 ganglioneuroblastoma (GNBL), and 20 ganglioneuroma samples in a multivariate model. ALK mutations were present in 2 of 72 NBL and 2 of 12 GNBL samples, which all contained many ALK-positive cells (>50%). In addition, half of all NBL samples showed ALK positivity in most (>50%) of tumor cells, whereas half of the GNBL showed staining in <20% of the tumor cells. In most ganglioneuroma samples, a low percentage of tumor cells stained positive for ALK, which mainly involved ganglion cells. Higher percentages of ALK-positive cells in NBL and GNBL patient samples correlated with inferior survival in univariate and multivariate analyses with established prognostic factors, such as stage, age, and MYCN status. In conclusion, ALK positivity by IHC is an independent, poor prognostic factor in patients with GNBL and NBL. ALK IHC is an easy test suitable for future risk stratification in patients with NBL and GNBL. PMID:22203052

Duijkers, Floor A M; Gaal, José; Meijerink, Jules P P; Admiraal, Pieter; Pieters, Rob; de Krijger, Ronald R; van Noesel, Max M



Prognostic factors in patients with advanced transitional cell carcinoma of the urothelial tract experiencing treatment failure with platinum-containing regimens.  


PURPOSE The present study sought to identify pretreatment prognostic factors for overall survival (OS) in patients with metastatic transitional cell carcinoma of the urothelial tract (TCCU) who experienced treatment failure with the first-line, platinum-based regimen included in the phase III vinflunine trial. PATIENTS AND METHODS In total, 370 patients with platinum-refractory TCCU were included in this analysis. Potential prognostic factors were recorded prospectively. Univariate analysis was used to identify clinical and laboratory factors that significantly impact survival. Multivariate analysis was used to identify independent prognostic factors, and bootstrap analysis was performed for internal validation, forming a prognostic model. External validation was performed on the phase II vinflunine study CA183001. RESULTS Multivariate analysis and the internal validation identified Eastern Cooperative Oncology Group performance status (PS) more than 0, hemoglobin level less than 10 g/dL, and the presence of liver metastasis as the main adverse prognostic factors for OS. External validation confirmed these prognostic factors. Four subgroups were formed based on the presence of zero, one, two, or three prognostic factors; the median OS times for these groups were 14.2, 7.3, 3.8, and 1.7 months (P < .001), respectively. CONCLUSION We identified and both internally and externally validated three adverse risk factors (PS, hemoglobin level, and liver metastasis) that predict for OS and developed a scoring system that classifies patients with platinum-refractory disease on second-line chemotherapy into four risk groups with different outcome. Similar to the first-line setting, the presence of visceral metastases and poor PS predict a worse prognosis. These factors, together with low hemoglobin, can be used for prognostication and future patient stratification in clinical trials. PMID:20231682

Bellmunt, Joaquim; Choueiri, Toni K; Fougeray, Ronan; Schutz, Fabio A B; Salhi, Yacine; Winquist, Eric; Culine, Stéphane; von der Maase, Hans; Vaughn, David J; Rosenberg, Jonathan E



Prospective multicenter comparison of proliferation and other prognostic factors in lymph node negative lobular invasive breast cancer.  


Evaluation of prognostic factors in lymph node negative (LNneg) invasive lobular cancers (ILCs). Prospective analysis of proliferation and other prognosticators in 121 LNneg ILCs (119 months median follow-up, range 19-181), without adjuvant chemotherapy. ILC subtype was assessed in accordance with WHO-2003 criteria. Immunohistochemical E-cadherin and estrogen receptor were used. With a median follow up time of 83 months (range 19-181), 30 of the 121 (25%) ILC patients developed distant metastases and 27 (22%) died. None of the cases classified as solid/pleomorphic lobular were E-cadherin or estrogen receptor positive, contrasting the other ILCs. The solid/alveolar ILCs (n = 17) had a worse survival (50%) than the other ILCs (n = 104; 83%, P < 0.0001). Mitotic activity index (MAI) (but not nuclear grade or tubule formation) was prognostic with a threshold 0-5 versus >5 (=MAI-5) (contrasting MAI < 10 vs. > or = 10 in breast cancers in general; 85 and 54% survival, P < 0.0001). In multivariate analysis only subtype and MAI but none of the other characteristics had independent prognostic value. Histologic subtype and MAI have independent prognostic value in node negative invasive lobular cancers. PMID:19568929

Gudlaugsson, Einar; Skaland, Ivar; Janssen, Emiel A M; van Diest, Paul J; Voorhorst, Feja J; Kjellevold, Kjell; zur Hausen, Axel; Baak, Jan P A



Energy and minorities, women, and the poor  

SciTech Connect

A comprehensive, up-to-date (1975 to 1980) bibliography of articles, books and other publications is presented dealing with the subject of energy and minorities, women and the poor. Included are academic, popular, and government publications as well as publications by private groups and organizations. It is intended for political scientists, sociologists, economists, home economists, energy planners, energy managers and others interested in the interface of minorities, women, and the poor with energy. Following a brief introduction, there is a general listing. Also included are references dealing with energy and black Americans, native Americans (Indians), the poor, and women. (MJJ)

Perry, H.L.; Perry, E.B.



Evaluation of prognostic factors in patients with therapy-related acute myeloid leukemia  

PubMed Central

Background Therapy-related AML (t-AML) occurs as a late complication of chemotherapy administered to treat a prior disorder. Prognostic factors affecting the clinical outcome in t-AML have not yet been clearly defined; therefore, we evaluated these factors in this study. Methods Forty-eight patients diagnosed with t-AML within the past 10 years were enrolled, and their chemotherapy regimens categorized into 4 groups: alkylating agents (AK) only, topoisomerase II inhibitors (TI) and AK, TI only, and others. The prognostic factors affecting clinical outcome were evaluated. Results Five (10.4%), 21 (43.8%), 9 (18.8%), and 13 (27.0%) patients were treated with AK only, AK and TI, TI only, and others, respectively. Patients with an AML M3 phenotype showed significantly longer overall survival (OS; 55.1 vs. 14.3 months, P=0.040) and disease-free survival (DFS; 61.2 vs. 17.5 months, P=0.049) than other phenotypes. In contrast, patients with a complex karyotype showed significantly shorter OS (7.9 vs. 31.3 months, P=0.008) and DFS (9.5 vs. 38.6 months, P=0.046); additionally, patients with chromosome 5 or 7 abnormalities showed significantly shorter OS (9.1 vs. 30.7 months, P=0.011) than other phenotypes. Only the presence of a complex karyotype or AML M3 phenotype retained prognostic impact in a multivariate analysis. Conclusion Only the AML M3 phenotype was identified as having a good prognosis, and this might suggest that it exhibits unique clinical features in t-AML patients. Moreover, our findings indicated that karyotype was the strongest prognostic indicator and predicted a poor prognosis for t-AML patients with a complex karyotype.

Park, Sang Hyuk; Cho, Young-Uk; Jang, Seongsoo; Park, Chan-Jeoung



Prognostic value of soluble MICA levels in the serum of patients with advanced hepatocellular carcinoma.  


Serum levels of soluble MHC class I-related chain A (sMICA) are related with the prognosis of various types of cancer; however, few studies on the prognostic value of sMICA in hepatocellular carcinoma (HCC) have been reported. In this study, we retrospectively investigated the relationship between sMICA levels and clinical features of advanced HCC, and we assessed the prognostic value of sMICA in advanced HCC. Furthermore, the relationship of serum sMICA levels and natural killer group 2, member D (NKG2D) expression on natural killer (NK) cells was also evaluated. We detected sMICA levels in the serum of 60 advanced HCC patients using enzyme-linked immunosorbent assay (ELISA) and measured expression levels of NKG2D on NK cells using flow cytometry. We found that serum sMICA levels in HCC patients were in the range of 0.10-6.21 ng/mL. Chi-square analyses showed that sMICA level was significantly related with only tumor size. Survival analysis showed that a high sMICA level was significantly related with poor prognosis among HCC patients. Multivariate analyses indicated that sMICA was an independent prognostic factor. In addition, the levels of CD56+NKG2D+ NK cells were within the range of 11.2%-55.4%, and correlation analyses indicated that sMICA level was negatively correlated with the level of NKG2D+ NK cells. Our results suggest that serum sMICA levels may be an independent prognostic factor for advanced HCC. PMID:22704489

Li, Jian-Jun; Pan, Ke; Gu, Mo-Fa; Chen, Min-Shan; Zhao, Jing-Jing; Wang, Hui; Liang, Xiao-Ting; Sun, Jian-Cong; Xia, Jian-Chuan



Efficacy of leflunomide addition in relation to prognostic factors for patients with active early rheumatoid arthritis failing to methotrexate in daily practice.  


The recommendations of the European League Against Rheumatism (EULAR) for the management of rheumatoid arthritis (RA) suggest a different therapeutic approach to methotrexate (MTX) resistance according to the presence or absence of poor prognostic factors. Retrospectively, in our patients with active early RA (disease activity score in 28 joints (DAS28)?>?3.2) that failed to respond to initial MTX monotherapy, we investigated whether leflunomide (LEF) addition had a different efficacy when associated with the presence or absence of poor prognostic factors. Of the 20 patients who received LEF, 15 (2 males and 13 females) tolerated the combination. Five patients had no poor prognostic factors, and 4 (80%) of those patients achieved remission or low disease activity (LDA) according to DAS28 and also a good response with the EULAR criteria. Of the 10 patients with at least one poor prognostic factor, remission or LDA occurred in 4 (40%) of the patients, and a good EULAR response was obtained in 3 (30%) of the patients. By Fisher's exact test, no significant difference was found between the two groups of patients in remission or LDA (p?=?0.28) according to DAS28 and a good response (p?=?0.12) with the EULAR criteria. In all patients with an inadequate response to the LEF+MTX combination, the substitution of a TNF inhibitor for LEF or the addition of a TNF inhibitor to the combination led to remission or LDA. Large studies are required to investigate the efficacy of LEF addition in relation to prognostic factors in patients with active early RA that did not respond to the initial therapy with MTX alone. PMID:21904814

Sakellariou, Grigorios T; Sayegh, Fares E; Kapetanos, George A; Berberidis, Charalampos



Overexpression of CARM1 in breast cancer is correlated with poorly characterized clinicopathologic parameters and molecular subtypes  

PubMed Central

Background Coactivator-associated arginine methyltransferase 1 (CARM1) belongs to the protein arginine methyltransferase family. CARM1 has been reported to be associated with high grade tumors in breast cancer. It still remains unknown the expression pattern of CARM1 in breast cancer and its relationships with clinicopathological characteristics and molecular subtypes. Methods Two hundred forty-seven invasive breast cancer cases were collected and prepared for tissue array. There were thirty-seven tumors with benign glandular epithelium adjacent to the tumors among these cases. Molecular subtype and CARM1 expression were investigated using immunohistochemistry. Results Cell staining was observed in the cytoplasm and/or nucleus. Staining for CARM1 was significantly stronger in adenocarcinoma compared with adjacent benign epithelium. There is a significant correlation between CARM1 overexpression with young age, high grade, estrogen receptor (ER) and progesterone receptor (PR) negative, increased p53 expression, and high Ki-67 index. Our study demonstrated CARM1 overexpression was associated with an increase in the protein expression of HER2. Furthermore, our data indicated CARM1-overexpression rate were remarkably higher in HER2 subtype (69.6%), luminal B subtype (59.6%) and TN subtype (57.1%) compared with luminal A subtype (41.3%). Conclusions CARM1 expression was increased in invasive breast cancer. CARM1 overexpression was associated with poorly characterized clinicopathologic parameters and HER2 overexpression. There were significant differences between different molecular subtypes in their relationship to CARM1 overexpression. Our results support the value of using CARM1 in prognostic stratification of breast cancer patients and its potential therapeutic implications in targeting treatment. Virtual slides The virtual slide(s) for this article can be found here:



Poor compliance: The hidden risk factor  

Microsoft Academic Search

Conclusions  Poor compliance with prescribed regimens remains a potent barrier to good outcomes in coronary heart disease and other chronic\\u000a diseases. Such poor compliance is related to disease, patient, provider, and treatment factors and has yet to be fully understood.\\u000a In general, the less complex the regimen, the better informed the patient and the physician, and the more serious the disease,

John C. LaRosa



Treating Cystic Fibrosis in Resource Poor Environment  

Microsoft Academic Search

Cystic fibrosis (CF) is now recognized as a pan-ethnic disease. Problems in management in resource poor setting includes: lack of awareness among clinicians, non-availability of sweat testing facility, non-availability of medications and shortage of trained health care personnel for management and poor networking among centers providing services for CF patients. We are trying to create awareness among pediatricians by using

SK Kabra; M Kabra; R Lodha; S Shastri


Constraining the Evolution of Poor Clusters  

NASA Astrophysics Data System (ADS)

There currently exists no method by which to quantify the evolutionary state of poor clusters (PCs). Research by Broming & Fuse (2010) demonstrated that the evolution of Hickson compact groups (HCGs) are constrained by the correlation between the X-ray luminosities of point sources and diffuse gas. The current investigation adopts an analogous approach to understanding PCs. Plionis et al. (2009) proposed a theory to define the evolution of poor clusters. The theory asserts that cannibalism of galaxies causes a cluster to become more spherical, develop increased velocity dispersion and increased X-ray temperature and gas luminosity. Data used to quantify the evolution of the poor clusters were compiled across multiple wavelengths. The sample includes 162 objects from the WBL catalogue (White et al. 1999), 30 poor clusters in the Chandra X-ray Observatory archive, and 15 Abell poor clusters observed with BAX (Sadat et al. 2004). Preliminary results indicate that the cluster velocity dispersion and X-ray gas and point source luminosities can be used to highlight a weak correlation. An evolutionary trend was observed for multiple correlations detailed herein. The current study is a continuation of the work by Broming & Fuse examining point sources and their properties to determine the evolutionary stage of compact groups, poor clusters, and their proposed remnants, isolated ellipticals and fossil groups. Preliminary data suggests that compact groups and their high-mass counterpart, poor clusters, evolve along tracks identified in the X-ray gas - X-ray point source relation. While compact groups likely evolve into isolated elliptical galaxies, fossil groups display properties that suggest they are the remains of fully coalesced poor clusters.

Broming, Emma J.; Fuse, C. R.



Defining a prognostic marker panel for patients with ovarian serous carcinoma effusion.  


Advanced-stage ovarian carcinoma is a highly lethal malignancy, yet no widely accepted prognostic panels exist to date in this disease. The objective of this study was to define such panel for patients with ovarian serous carcinoma effusions. The expression by immunohistochemistry and clinical role of 41 previously studied cancer-associated proteins was analyzed in 143 effusions from patients diagnosed as having advanced-stage (International Federation of Gynecology and Obstetrics stages III-IV) ovarian serous carcinoma treated with platinum-based chemotherapy at diagnosis. Survival analyses were performed separately for patients with prechemotherapy and postchemotherapy effusions. In univariate analysis of patients with primary diagnosis prechemotherapy effusions, survivin was associated with longer progression-free survival (P = .03), whereas survivin (P = .009), signal transducer and activator of transcription 5B (P = .011), and p21-activated kinase-1 (P = .04) were markers of longer overall survival. In univariate analysis of patients with disease recurrence postchemotherapy effusions, peroxisome proliferator-activated receptor-? (P = .004), human leukocyte antigen-G (P = .013), mammalian target of rapamycin (P = .04), and nucleus accumbens 1 (NAC-1) (P = .046) were associated with poor progression-free survival, whereas peroxisome proliferator-activated receptor-? (P = .013), claudin-3 (P = .019), activator protein-2? (P = .04), insulin-like growth factor-2 (P = .04), claudin-7 (P = .042), and fatty acid synthase (P = .048) were markers of poor overall survival. In Cox multivariate analysis for prechemotherapy cases, survivin and fatty acid synthase were independent predictors of better progression-free survival (P = .006 and P = .048, respectively), and signal transducer and activator of transcription 5B and heat shock protein 90 were independently associated with better overall survival (P = .033 and P = .006, respectively). None of the biological markers was an independent prognostic factor in recurrent disease. The present study represents the first attempt at prognostic stratification of multiple tumor markers in one cohort of patients with ovarian serous carcinoma effusions. PMID:24011953

Davidson, Ben; Smith, Yoav; Nesland, Jahn M; Kærn, Janne; Reich, Reuven; Tropè, Claes G



Does the expression of BCL2 have prognostic significance in malignant peritoneal mesothelioma?  

PubMed Central

Background Malignant peritoneal mesothelioma (MPM) is a rare neoplasm of the peritoneal membrane that is causally related to asbestos exposure. Survival after treatment is poor. Current therapy involving hyperthermic intraperitoneal chemotherapy has improved survival in selective patients. In the past, several prognostic factors have been identified in MPM patients and this has prompted the development of new therapies and patient management. Since BCL2, an antiapoptotic oncoprotein, is a favourable prognostic factor in breast cancer, we investigated to determine the significance of BCL2 in MPM. Materials and Methods Forty two archival patient tumour sections embedded in paraffin blocks were sectioned and subjected to immunohistochemistry to detect BCL2. The staining intensity and abundance was classified using standard procedures and classified into two groups (0-4 = low & 5-8 = high expression). The distribution of BCL2 groups was examined in the different clinicopathological categories to determine prognosis using Kaplan–Meier survival analysis. Results: Univariate analysis revealed that in almost all clinicopathological categories, high BCL2 expression predisposed patients to a favourable prognosis. Independent of BCL2 expression, univariate analysis also showed that male gender, sarcomatoid histology, high PCI and age at diagnosis ? 60 years were associated poor prognosis. Multivariate analysis indicated that for all tumours, males and females, high BCL2 expression was associated with good prognosis. Further, independent of BCL2, age ? 60 years is an unfavourable prognostic factor. Conclusion: Expression of BCL2 may serve to distinguish prognosis within the individual clinicopathological categories. BCL2 is also an independent variable in all tumours, males and females, with high expression being associated with good prognosis.

Pillai, Krishna; Pourgholami, Mohammad H; Chua, Terence C; Morris, David L



Inflammatory and microRNA Gene Expression as Prognostic Classifiers of Barrett's Associated Esophageal Adenocarcinoma  

PubMed Central

Purpose Esophageal cancer is one of the most aggressive and deadly forms of cancer; highlighting the need to identify biomarkers for early detection and prognostic classification. Our recent studies have identified inflammatory gene and microRNA signatures derived from tumor and nontumor tissues as prognostic biomarkers of hepatocellular, lung, and colorectal adenocarcinoma. Here, we examine the relationship between expression of these inflammatory genes and miRNA expression in esophageal adenocarcinoma and patient survival. Experimental Design We measured the expression of 23 inflammation-associated genes in tumors and adjacent normal tissues from 93 patients (58 Barrett's and 35 Sporadic adenocarcinomas) by quantitative reverse transcription-polymerase chain reaction. These data were used to build an inflammatory risk model, based on multivariate Cox regression, to predict survival in a training cohort (n=47). We then determined if this model could predict survival in a cohort of 46 patients. Expression data for miRNA-375 was available for these patients and was combined with inflammatory gene expression. Results IFN?, IL-1?, IL-8, IL-21, IL-23, and PRG expression in tumor and nontumor samples were each associated with poor prognosis based on Cox regression ([Z-score]>1.5) and therefore, were used to generate an inflammatory risk score (IRS). Patients with a high IRS had poor prognosis compared to those with a low IRS in the training (P=0.002) and test (P=0.012) cohorts. This association was stronger in the group with Barrett's history. When combining with miRNA-375, the combined IRS/miR signature was an improved prognostic classifier than either one alone. Conclusion Transcriptional profiling of inflammation-associated genes and miRNA expression in resected esophageal Barrett's associated adenocarcinoma tissues may have clinical utility as predictors of prognosis.

Nguyen, Giang Huong; Schetter, Aaron J.; Chou, David B.; Bowman, Elise D.; Zhao, Ronghua; Hawkes, Jason E.; Mathe, Ewy A.; Kumamoto, Kensuke; Zhao, Yiqiang; Budhu, Anuradha; Hagiwara, Nobutoshi; Wang, Xin Wei; Miyashita, Masao; Casson, Alan G.; Harris, Curtis C.



Prognostic factors for survival in stage IIIB and IV Hodgkin's disease: a multivariate analysis comparing two specialist treatment centres.  

PubMed Central

A multivariate analysis of prognostic factors was carried out on 301 patients with clinical or pathological stage III/IV Hodgkin's disease treated using the same combination chemotherapy (MVPP) at two centres (Christie Hospital, Manchester, 151 patients, St. Bartholomew's Hospital, London, 150 patients). There were no significant difference in CR or relapse free and overall survival at 5 and 10 years between the two groups. Cox analysis of the Christie data alone produced four significant factors for survival - age, sex, lymphocyte count and stage. The latter three factors showed the same trend for the St. Bartholomew's Hospital patients but failed to reach statistical significance. Analysis of the combined data showed all four factors to be of importance in predicting survival. Three different prognostic groups were identified which separated patients with good, intermediate or poor prognosis in both centres. The good prognostic group included patients aged less than 45 years, lymphocyte count greater than 0.75 x 10(9) l-1 and female patients with stage IIIB disease (5 year survival 85%). The rest were of poorer prognosis with male stage IV patients faring particularly badly (5 year survival 40%). Problems associated with the use of multivariate analysis to produce useful prognostic groupings in patients from different centres, are discussed.

Wagstaff, J.; Gregory, W. M.; Swindell, R.; Crowther, D.; Lister, T. A.



Novel prognostic markers for patients with triple-negative breast cancer.  


Triple-negative breast cancer (TNBC) is a subtype of breast cancer characterized by poor prognosis. Currently, no reliable markers have been identified as having a predictive role for the prognosis of TNBC patients. In this study, 119 breast cancer samples, including 31 TNBC and 89 non-TNBC subtypes, were collected. The protein levels of cleaved caspase-3 (CC3), aldehyde dehydrogenase 1 (ALDH1), cyclooxygenase-2, Ki-67, H2A histone family member X, and phosphorylated protein kinase B protein were measured by immunohistochemical staining. The percentage of positive CC3 (P = .017), ALDH1 (P = .015), Ki-67 (P = .001), and H2A histone family member X (P = .016) staining was significantly higher in TNBC than in non-TNBC cases. Positive CC3 and ALDH1 staining significantly correlated with poor prognosis of breast cancer, the TNBC subtype and non-TNBC subtype. Positive cyclooxygenase-2 expression significantly correlated with the survival of patients with TNBC. Multivariate analysis demonstrated that CC3 and ALDH1 are independent prognostic factors for BC and non-TNBC. ALDH1 is a prognostic marker for TNBC patients. PMID:23845466

Zhou, Ling; Li, Ke; Luo, Yanli; Tian, Ling; Wang, Min; Li, Chuanyuan; Huang, Qian



Prognostic significance of overexpression of c-Met oncoprotein in cholangiocarcinoma  

PubMed Central

Background: Cholangiocarcinoma (CC) is a highly malignant carcinoma. We attempted to clarify the prognostic significance of c-Met overexpression and its association with clinicopathological factors in patients with CC. Patients and methods: One hundred and eleven patients with intrahepatic CC (IHCC) and 136 patients with extrahepatic CC (EHCC) who had undergone curative surgery were divided immunohistologically into c-Methigh and c-Metlow groups. Clinicopathological factors and outcomes were compared between the groups. c-Met and epidermal growth factor receptor (EGFR) expression was also examined in 10 CC cell lines. Results: The positivity of c-Met was 45.0% in IHCC and 68.4% in EHCC; c-Methigh expression was demonstrated in 11.7% of IHCC and 16.2% of EHCC. c-Methigh expression was significantly correlated with the 5-year survival rate for CC overall (P=0.0046) and for IHCC (P=0.0013), histopathological classification in EHCC, and for EGFR overexpression in both IHCC and EHCC. Coexpression and coactivation of c-Met and EGFR were also observed in CC cell lines. Multivariate analysis revealed that c-Methigh expression was an independent predictor of poor overall and disease-free survival in patients with IHCC. Conclusions: c-Met overexpression is associated with EGFR expression and is a poor prognostic factor in CC.

Miyamoto, M; Ojima, H; Iwasaki, M; Shimizu, H; Kokubu, A; Hiraoka, N; Kosuge, T; Yoshikawa, D; Kono, T; Furukawa, H; Shibata, T



Prognostic value of histologic and immunohistochemical features in feline cutaneous mast cell tumors.  


Feline cutaneous mast cell tumors (MCTs) have been histologically classified as mastocytic (well differentiated or pleomorphic) and atypical/poorly granulated. Their biologic behavior ranges from benign to malignant, but prognostic factors are not well defined. Histologic classification, number of tumors, mitotic index, cytoplasmic granularity, and infiltration by eosinophils or lymphocytes were evaluated retrospectively in 25 feline cutaneous MCTs. Immunohistochemistry was applied to assess KIT (CD117) pattern and immunoreactivity score, telomerase expression (human telomerase reverse transcriptase), and proliferation index (MIB-1/Ki67 index). Case outcome was obtained via telephone interviews. The tumors comprised 15 mastocytic well-differentiated, 7 mastocytic pleomorphic, and 3 atypical/poorly granulated MCTs. Immunohistochemically, CD117 was expressed in 13 of 25 tumors (52%), and telomerase reverse transcriptase was expressed in 15 of 22 (68%), with no correlation to histologic classification. Mitotic index, KIT immunoreactivity score, and Ki67 index were significantly higher in mastocytic pleomorphic MCTs than in the other 2 categories. Five cats (20%) died of tumor-related causes. Multiplicity of lesions, pleomorphic phenotype, KIT immunoreactivity score, and mitotic and Ki67-indices correlated with an unfavorable outcome. Mitotic index was the strongest predictive variable. These results suggest that histologic classification, CD117/KIT immunohistochemistry, and proliferation indices may help to identify potentially aggressive cases of feline cutaneous MCT. Aberrant KIT protein localization and telomerase immunoreactivity warrant further exploration as potential prognostic markers. PMID:20418469

Sabattini, S; Bettini, G



Prognostic factors after resection of colorectal liver metastases: from morphology to biology.  


Despite improved overall survival rates after potentially curative liver resection (~50-58% at 5 years), almost half of patients experience disease recurrence highlighting the need for a precise definition of outcomes to stratify patients for clinical trials and to guide treatment decisions. In the past, several factors, such as an advanced primary T stage, the primary N+ status, a large tumor size, multiple tumors, a disease-free interval of <12 months, an elevated carcinoembryonic antigen level, the presence of an extrahepatic disease, and the margin width (<1 cm) and status (positive), have been recognized to predict poor outcomes, but most of them lack the sensitivity for accurate individual prognostication. Thus, in recent years, new factors, such as response to chemotherapy, either clinical or pathological, that more closely reflect tumor biology have been established and adopted in the clinical practice. Similarly, biomarkers of poor prognosis, especially mutations in KRAS and BRAF and the expression of thymidylate synthase, have been studied, yielding promising results. However, robust evidence of their prognostic utility awaits prospective validation. PMID:23252563

Ribero, Dario; Viganò, Luca; Amisano, Marco; Capussotti, Lorenzo



Poor prognostic significance of Mycobacterium tuberculosis infection during bortezomib-containing chemotherapy in patients with multiple myeloma  

PubMed Central

Background Bortezomib administration leads to a transient decrease in CD4+ T cells, increasing the susceptibility to opportunistic infections. The activation and proliferation of CD4+ T cells are particularly important in the host's defense against tuberculosis infection. The aim of this study was to determine the incidence and clinical significance of tuberculosis infection in patients with multiple myeloma (MM) treated with a bortezomib-containing regimen. Methods We retrospectively investigated the incidence of Mycobacterium tuberculosis in 115 patients with MM who were given a bortezomib-containing regimen and studied the disease prognosis. Results All patients received chemotherapy prior to bortezomib administration, and the median duration from diagnosis to bortezomib administration was 12.4 months (range, 0.2-230). We diagnosed tuberculosis in 8 patients (8/115, 7%): 7 patients had a pulmonary granulomatous lesion prior to chemotherapy and 1 developed reactivation of tuberculosis, but none of them died of uncontrolled tuberculosis infection. In 50% of patients with tuberculosis, bortezomib-containing therapy was interrupted. This resulted in significantly lower response rates to the bortezomib-containing therapy (P<0.05) and significantly shorter overall survival times amongst tuberculosis vs. non-tuberculosis patients (P=0.017). Conclusion Tuberculosis infection was not uncommon among the patients with MM who were treated with bortezomib-containing therapy, and tuberculosis infection in these patients resulted in an interruption of bortezomib administration, which significantly affected patient outcomes. Therefore, early diagnosis and treatment of tuberculosis infection are critical to avoid worsening outcomes in such patients.

Ahn, Jae-Sook; Rew, Sung Yoon; Yang, Deok-Hwan; Jung, Sung-Hoon; Kang, Seung-Ji; Kim, Mi-Young; Lee, Seung-Shin; Kim, Yeo-Kyeoung; Kim, Hyeoung-Joon



Prognostic significance of lymphangiogenesis in pharyngolaryngeal carcinoma patients  

PubMed Central

Background Lymphatic vessel spread is considered a major route for head and neck squamous cell carcinoma metastasis. Formation of new lymphatic vessels could facilitate the process, raising the malignant potential of these tumours. Recent identification of lymphatic markers allows the study of the lymphangiogenesis phenomenon. We searched for molecular events involved in the lymphangiogenic process that could have prognostic value in laryngeal/pharyngeal carcinoma patients. Methods 104 paraffin-embedded pharyngeal/laryngeal tumour samples were studied. Immunohistochemical analysis of podoplanin and double immunofluorescence analysis of Ki-67 and D2-40 were performed. Lymph vessel density (inside the tumour mass, at its periphery or considered as a whole) and the presence of tumour emboli inside lymphatics were recorded. The proliferative state of endothelial lymphatic cells was evaluated. Results Lymphatic vessels were detected inside the tumour mass (75%) and in the surrounding tissue (80%); some of them in a proliferative state. Tumour emboli were detected in a high proportion of the cases (45%). Lymphatic vessel density was higher in the pharyngeal cases (p = 0.0029), in greater size (p = 0.039), more advanced stage primary tumours (p = 0.006) and in carcinomas of patients with affected nodes (p = 0.019). The presence of tumour emboli and a high global vessel density were indicators of poor prognosis (recorded as death from tumour) in the laryngeal group (p = 0.015 and p = 0.027, respectively), but notably not in the pharyngeal one. Interestingly, high global vessel density showed a negative prognostic value among pathologically staged N0 laryngeal carcinomas (p = 0.03). Conclusions The lymphangiogenic process correlated with aggressive tumour features (pN category, tumour size, tumour stage), but might play different roles in tumours arising from different anatomic sites. Our results suggest that detection of tumour emboli and assessment of global vessel density using the D2-40 antibody, may be useful in the clinical practice, as predictors of reduced survival among pN0 laryngeal carcinoma patients.



Adult primitive neuroectodermal tumors: the prognostic value of supratentorial location.  


Primitive neuroectodermal tumors (PNETs) are tumors which primarily consist of undifferentiated round neuroepithelial cells. Central nervous system PNETs can be divided into two genetically distinct groups: infratentorial PNET (iPNET)/medulloblastoma and supratentorial PNET (sPNET). Currently, the comparative outcome of adult patients with sPNETs and iPNETs is unknown. In this study we have utilized the Surveillance, Epidemiology, and End Results database to perform a comparative analysis of 103 cases of adult sPNET and 669 adult medulloblastoma cases. Additionally we have analyzed various factors to identify their prognostic significance and characterize the optimal treatment for these tumors. Patients with sPNETs were seen to have a significantly worse survival than those diagnosed with medulloblastomas (16 vs. 155 months, p < 0.0001). Elderly patients (15 vs. 114 months, p < 0.0001) and those over the age of 40 (68 vs. 147 months, p < 0.0001) experienced significantly worse survival than younger patients. In contrast, radiotherapy (143 vs. 26 months, p < 0.0001), surgical resection (116 vs. 22 months, p = 0.0010) and the extent of resection (EOR) (173 vs. 81 months, p = 0.0005) resulted in significantly improved patient survival. Multivariate analysis revealed age greater than 40 years (HR: 1.57; 95 % CI: 1.17-2.11; p = 0.0028) and sPNET pathology (HR: 3.41; 95 % CI: 2.47-4.72; p < 0.0001) to be poor prognostic factors for survival while radiotherapy (HR: 0.52; 95 % CI: 0.38-0.71; p < 0.0001) and the EOR (HR: 0.73; 95 % CI: 0.55-0.96; p = 0.023) were associated with significantly improved survival. The treatment of sPNETs should therefore include maximal surgical resection when feasible followed by radiotherapy as these treatments have been demonstrated to confer a survival benefit. Additional studies are needed to identify effective chemotherapeutics and specific treatment regimens for adults with sPNETs. PMID:23720066

Gandhi, Rikesh; Babu, Ranjith; Cummings, Thomas J; Adamson, Cory



A multifactorial prognostic index in multiple sclerosis  

Microsoft Academic Search

Background\\u000a   The ability to predict the future progression of MS represents a key issue for the neurologist. The aim of the study was to\\u000a create a multifactorial prognostic index (MPI) providing the probability of a severe MS course at diagnosis based on clinical\\u000a and immunological CSF parameters.\\u000a \\u000a \\u000a \\u000a \\u000a Methods\\u000a   64 clinically definite relapsing-remitting (RR)MS patients (38 benign, 26 severe MS) followed

Jessica Mandrioli; Patrizia Sola; Roberta Bedin; Mariaelena Gambini; Elisa Merelli



Prognostic factors in pediatric Hodgkin disease.  


The sensitivity of pediatric Hodgkin disease to radiation and chemotherapy has resulted in cure for most children and adolescents who have been diagnosed in the past three decades. Identification of prognostic factors in clinical trials has allowed for tailoring of therapeutic approaches to improve outcome in sequential trials. Tumor burden, symptoms, clinical features, pathology, response to therapy, biology, and host factors are reviewed in this context. New developments should be directed toward identification of factors associated with biologic mechanisms of disease to facilitate the development of biologically targeted therapies that will be more efficacious and less toxic. PMID:14521809

Schwartz, Cindy L



Presence of epidermal growth factor receptor as an indicator of poor prognosis in patients with breast cancer.  

PubMed Central

Epidermal growth factor receptors are present in some breast cancers in man, and there is an inverse relation to oestrogen receptor state. We assessed the presence of epidermal growth factor receptors as a single prognostic indicator in a series of breast tumours by comparing this with the Bloom and Richardson scores for these tumours. One hundred and eight ductal tumours were examined for epidermal growth factor receptors by radioligand binding. There was a significant (p less than 0.01) correlation between the presence of the growth factor receptor and poor prognosis as assessed by the Bloom and Richardson score, suggesting that epidermal growth factor receptor state could be a useful prognostic marker. Epidermal growth factor receptor state was not significantly correlated with the lymph node state but showed a tendency to be associated with large tumours.

Sainsbury, J R; Malcolm, A J; Appleton, D R; Farndon, J R; Harris, A L



Prognostic cell biological markers in cervical cancer patients primarily treated with (chemo)radiation: a systematic review.  


The aim of this study was to systematically review the prognostic and predictive significance of cell biological markers in cervical cancer patients primarily treated with (chemo)radiation. A PubMed, Embase, and Cochrane literature search was performed. Studies describing a relation between a cell biological marker and survival in ?50 cervical cancer patients primarily treated with (chemo)radiation were selected. Study quality was assessed, and studies with a quality score of 4 or lower were excluded. Cell biological markers were clustered on biological function, and the prognostic and predictive significance of these markers was described. In total, 42 studies concerning 82 cell biological markers were included in this systematic review. In addition to cyclooxygenase-2 (COX-2) and serum squamous cell carcinoma antigen (SCC-ag) levels, markers associated with poor prognosis were involved in epidermal growth factor receptor (EGFR) signaling (EGFR and C-erbB-2) and in angiogenesis and hypoxia (carbonic anhydrase 9 and hypoxia-inducible factor-1?). Epidermal growth factor receptor and C-erbB-2 were also associated with poor response to (chemo)radiation. In conclusion, EGFR signaling is associated with poor prognosis and response to therapy in cervical cancer patients primarily treated with (chemo)radiation, whereas markers involved in angiogenesis and hypoxia, COX-2, and serum SCC-ag levels are associated with a poor prognosis. Therefore, targeting these pathways in combination with chemoradiation may improve survival in advanced-stage cervical cancer patients. PMID:21195874

Noordhuis, Maartje G; Eijsink, Jasper J H; Roossink, Frank; de Graeff, Pauline; Pras, Elisabeth; Schuuring, Ed; Wisman, G Bea A; de Bock, Geertruida H; van der Zee, Ate G J



Poor Sleep in Patients with Multiple Sclerosis  

PubMed Central

Background Poor sleep is a frequent symptom in patients with multiple sclerosis (MS). Sleep may be influenced by MS-related symptoms and adverse effects from immunotherapy and symptomatic medications. We aimed to study the prevalence of poor sleep and the influence of socio-demographic and clinical factors on sleep quality in MS- patients. Methods A total of 90 MS patients and 108 sex-and age- matched controls were included in a questionnaire survey. Sleep complaints were evaluated by Pittsburgh Sleep Quality Index (PSQI) and a global PSQI score was used to separate good sleepers (?5) from poor sleepers (>5). Excessive daytime sleepiness, the use of immunotherapy and antidepressant drugs, symptoms of pain, depression, fatigue and MS-specific health related quality of life were registered. Results were compared between patients and controls and between good and poor sleepers among MS patients. Results MS patients reported a higher mean global PSQI score than controls (8.6 vs. 6.3, p?=?0.001), and 67.1% of the MS patients compared to 43.9% of the controls (p?=?0.002) were poor sleepers. Pain (p?=?0.02), fatigue (p?=?0.001), depression (p?=?0.01) and female gender (p?=?0.04) were associated with sleep disturbance. Multivariate analyses showed that female gender (p?=?0.02), use of immunotherapy (p?=?005) and a high psychological burden of MS (p?=?0.001) were associated with poor sleep among MS patients. Conclusions Poor sleep is common in patients with MS. Early identification and treatment of modifiable risk factors may improve sleep and quality of life in MS.

B?e Lunde, Hanne Marie; Aae, Tommy F.; Indrevag, William; Aarseth, Jan; Bjorvatn, Bj?rn; Myhr, Kjell-Morten; B?, Lars



IVF conversion to IUI in poor responders: an observational study  

Microsoft Academic Search

Purpose  The purpose of this study was to evaluate the significance of converting an IVF stimulation cycle with poor ovarian response\\u000a to an IUI cycle.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Between January and December 2007, 47 cycles of IVF conversion to IUI were retrospectively studied in 44 infertile women who\\u000a had a low response to ovarian hyperstimulation for IVF. Patients’ characteristics, ovarian stimulation, and ovarian response

Thomas Freour; Sophie Dubourdieu; Sophie Mirallie; Marie Laure Langlois; Miguel Jean; Paul Barrière



HLA Markers for Poor Prognosis in Systemic Sclerosis Brazilian Patients  

PubMed Central

Objectives. The aim of this study was to evaluate human leukocyte antigen (HLA) involvement in the disease expression and poor prognostic clinical features (pulmonary fibrosis and pulmonary arterial hypertension) in patients diagnosed with systemic sclerosis (SSc) in a multiethnic population. Methods. SSc patients followed up between 2008 and 2011 were included, and clinical data were obtained through records review. Molecular HLA typing was performed (polymerase chain reaction amplification technique using specific primer sequences). The statistical analysis involved Fisher's exact test and Pearson's corrected chi-square test. P??values ? 0.05 were considered significant. The delta method was used to estimate the variance of the prevalence ratio (PR). Results. A total of 141 patients (120 women and 21 men) with SSc were studied, including 33.3% with diffuse cutaneous SSc (dcSSc), 62.4% with limited cutaneous SSc (lcSSc), and 4.3% with sine scleroderma. Pulmonary fibrosis was present in 61 patients (43.3%), and the HLA-A?30 and DQB1?04 alleles were related to susceptibility. In contrast, the HLA-DRB1?01 and DQB1?05 alleles were protective. Pulmonary arterial hypertension was diagnosed in 19 patients (13.5%) and was associated with HLA-B?35 and C?04; in contrast, C?03 seemed to be protective. Conclusions. Our current study documents the association of some classes I and II HLA alleles with the most severe clinical manifestations in a multiethnic case series. Our findings differed slightly from the previous data in other populations.

Del Rio, Ana Paula Toledo; Sachetto, Zoraida; Sampaio-Barros, Percival Degrava; Marques-Neto, Joao Francisco; Londe, Ana Carolina Santos; Bertolo, Manoel Barros



Diagnostic and Prognostic Value of Serum Albumin for Tuberculosis in HIV Infected Patients Eligible for Antiretroviral Therapy: Datafrom an HIV Cohort Study in India  

PubMed Central

Introduction: Tuberculosis is difficult to diagnose and it is the leading cause of death in HIV infected individuals in developing countries. There is an urgent need of low-cost diagnostic markers for resource-limited settings. Methods: The study involved 1571 patients from an HIV cohort study in India with known serum albumin concentrations at the time of becoming eligible for antiretroviral therapy (ART). We investigated the diagnostic accuracy of serum albumin to predict tuberculosis within six months of ART eligibility and the prognostic value in patients who experienced tuberculosis. Results: The diagnostic accuracy of serum albumin, measured by the area under the receiver operating characteristic curve, to predict tuberculosis was 0.81 (95% confidence interval 0.78-0.83). Serum albumin concentrations <3.2 g/dL were associated with 85% specificity and <4.1 g/dL were associated with negative predictive values >90%, even in settings with high tuberculosis prevalence. Hypoalbuminemia was associated with an increased risk of mortality in patients with tuberculosis. Conclusion: Serum albumin can be a useful low-cost diagnostic marker for tuberculosis in HIV infected patients eligible for ART. However, we failed to find thresholds to rule out or rule in tuberculosis. If these results are confirmed by other studies, serum albumin could be used to improve the diagnostic accuracy of intensive case finding algorithms for HIV-related tuberculosis. In patients who experience tuberculosis, hypoalbuminemia is associated with poor prognosis.

Alvarez-Uria, Gerardo; Midde, Manoranjan; Pakam, Raghavakalyan; Naik, Praveen Kumar



[Effect of beta adrenergic blocking drugs on the prognostic value of ST-segment depression during exercise electrocardiogram testing].  


Exercise testing has been shown to be predictive for future cardiac events in patients with established diagnosis of coronary heart disease. Exercise test parameters associated with poor prognosis may be unreliable if patient is receiving beta adrenergic agents. The purpose of this study was: 1) to compare the results of exercise testing performed before and during beta blocking therapy, and 2) to determine the role of beta blockers in the prognostic significance of the ST-segment response recorded during exercise testing. The study population consisted of 518 patients (mean age 52 +/- 7 years) with coronary heart disease. The diagnosis was based on the presence of one of the following three criteria: 1) typical history and significant ST-segment depression on resting or exercise electrocardiogram, 2) history of myocardial infarction, 3) significant coronary angiographic abnormalities. In all patients symptom-limited exercise test was performed before and two weeks after the onset of beta blocker therapy. The data from the first and second tests were estimated for significance of differences between the mean values with following results: maximal heart rate--135 +/- 21 and 123 +/- 19 bpm (p less than 0.001), maximal work load achieved--98 +/- 43 and 109 +/- 44 W (p less than 0.001), maximal systolic blood pressure--171 +/- 28 and 163 +/- 26 mmHg (p less than 0.001). Occurrence of characteristic ST-segment depression was more frequent during the first than during the second test (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1351545

Dabrowski, A; Kubik, L; Piotrowicz, R; Giec, L; Kuch, J; Pasyk, S; Piwowarska, W; Pracka, H; Sadowski, Z; Trusz-Gluza, M



Neuroblastoma and bone metastases: clinical significance and prognostic value of Dickkopf 1 plasma levels.  


The critical role of the Wnt pathway inhibition in sustaining the onset of bone lesions has been demonstrated in a variety of bone diseases and tumors, and it has been associated with cancer aggressiveness. We have previously demonstrated that neuroblastoma cells express Dickkopf 1 (Dkk1), an inhibitor of the canonical Wnt pathway which prevents the differentiation of bone-forming cells. Since Dkk1 is a secreted factor, it could have potential clinical application as tumor marker for detecting bone metastasis and monitoring of disease. In this study, we investigated the diagnostic and prognostic value of Dkk1 plasma levels in 92 children affected by neuroblastoma, including 32 with bone metastases. Fifty-seven children hospitalized for minor surgical problems served as control group. Circulating levels of Dkk1 were higher in healthy children than in normal adults and were comparable to those found in adult patients with aggressive tumors. No significant differences were found between neuroblastoma patients and controls and between patients with and without bone metastases. However, when only patients with metastatic neuroblastoma were considered, the highest Dkk1 levels were detected in patients that poorly responded to induction chemotherapy and in subjects with unamplified MYCN and three or more different metastatic sites. The 'Receiver Operating Characteristic' curve enabled us to identify a threshold value to distinguish patients who were unresponsive to induction treatment. The relationship between Dkk1 and drug resistance was supported by in vitro experiments, since an increased sensitivity to doxorubicin was found in neuroblastoma cells releasing low Dkk1 levels, either constitutively or experimentally following the treatment with specific siRNA. In conclusion, Dkk1 is released by neuroblastoma cells and is able to affect the balance between osteoblastogenesis and osteoclastogenesis, thus favoring the onset of osteolytic metastases. Nevertheless, Dkk1 plasma levels do not allow the detection of bone lesions in neuroblastoma but seem to have a predictive value with regard to the severity and the prognosis of the disease in a subset of patients with metastatic tumor. New knowledge on the biological role of Dkk1 in driving the natural history of neuroblastoma has to be further investigated and could help to establish specific therapeutic strategies able to target key factors of tumor progression. PMID:20603237

Granchi, Donatella; Corrias, Maria Valeria; Garaventa, Alberto; Baglìo, Serena Rubina; Cangemi, Giuliana; Carlini, Barbara; Paolucci, Paolo; Giunti, Armando; Baldini, Nicola



Long-term Prognostic Role of Functional Limitations Among Women With Breast Cancer  

PubMed Central

Background The long-term prognostic role of functional limitations among women with breast cancer is poorly understood. Methods We studied a cohort of 2202 women with breast cancer at two sites in the United States, who provided complete information on body functions involving endurance, strength, muscular range of motion, and small muscle dexterity following initial adjuvant treatment. Associations of baseline functional limitations with survival were evaluated in delayed entry Cox proportional hazards models, with adjustment for baseline sociodemographic factors, body mass index, smoking, physical activity, comorbidity, tumor characteristics, and treatment. Difference in covariates between women with and without limitations was assessed with Pearson ?2 and Student t tests. All statistical tests were two-sided. Results During the median follow-up of 9 years, 112 deaths were attributable to competing causes (5% of the cohort) and 157 were attributable to breast cancer causes (7% of the cohort). At least one functional limitation was present in 39% of study participants. Proportionately, more breast cancer patients with functional limitations after initial adjuvant treatment were older, less educated, and obese (P < .001). In multivariable models, functional limitations were associated with a statistically significantly increased risk of death from all causes (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.03 to 1.92) and from competing causes (HR = 2.60, 95% CI = 1.69 to 3.98) but not from breast cancer (HR = 0.90, 95% CI = 0.64 to 1.26). The relationship between functional limitations and overall survival differed by tumor stage (among women with stage I and stage III breast cancer, HR = 2.02, 95% CI = 1.23 to 3.32 and HR = 0.74, 95% CI = 0.42 to 1.30, respectively). Conclusion In this prospective cohort study, functional limitations following initial breast cancer treatment were associated with an important reduction in all-cause and competing-cause survival, irrespective of clinical, lifestyle, and sociodemographic factors.

Satariano, William A.; Sternfeld, Barbara; Hiatt, Robert A.; Ganz, Patricia A.; Kerlikowske, Karla; Moore, Dan H.; Slattery, Martha L.; Tammemagi, Martin; Castillo, Adrienne; Melisko, Michelle; Esserman, Laura; Weltzien, Erin K.; Caan, Bette J.



High CRP values predict poor survival in patients with penile cancer  

PubMed Central

Background High levels of circulating C-reactive protein (CRP) have recently been linked to poor clinical outcome in various malignancies. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP level in patients with squamous cell carcinoma (SCC) of the penis. Methods This retrospective analysis included 79 penile cancer patients with information about their serum CRP value prior to surgery who underwent either radical or partial penectomy at two German high-volume centers (Ulm University Medical Center and Hannover Medical School) between 1990 and 2010. They had a median (mean) follow-up of 23 (32) months. Results A significantly elevated CRP level (>15 vs. ? 15?mg/l) was found more often in patients with an advanced tumor stage (?pT2) (38.9 vs. 11.6%, p=0.007) and in those with nodal disease at diagnosis (50.0 vs. 14.6%, p=0.007). However, high CRP levels were not associated with tumor differentiation (p=0.53). The Kaplan-Meier 5-year cancer-specific survival (CSS) rate was 38.9% for patients with preoperative CRP levels above 15?mg/l and 84.3% for those with lower levels (p=0.001). Applying multivariate analysis and focusing on the subgroup of patients without metastasis at the time of penile surgery, both advanced local tumor stage (?pT2; HR 8.8, p=0.041) and an elevated CRP value (>15?mg/l; HR 3.3, p=0.043) were identified as independent predictors of poor clinical outcome in patients with penile cancer. Conclusions A high preoperative serum CRP level was associated with poor survival in patients with penile cancer. If larger patient populations confirm its prognostic value, its routine use could enable better risk stratification and risk-adjusted follow-up of patients with SCC of the penis.



Prognostic fire algorithm in CLM-CN  

NASA Astrophysics Data System (ADS)

Fire is an important Earth System process. It constitutes one of the most important feedbacks between global carbon and the hydrological cycle. Despite of the importance of fire in the climate system it is yet not well understood nor it is well represented within coupled carbon-climate models used to study climate change. To improve our understanding of this feedback linked to changes in the hydrological cycle we aim for a detailed consideration of fires within the fully coupled CCSM3 model. The current version of the land model within CCSM (CLM-CN) includes a prognostic fire algorithm based on Thonicke et al. 2001 in which fire emissions occur when climatic conditions are sufficiently dry and there is sufficient litter available. We extended the model by an alternative fire algorithm based on the work by Arora and Boer (2004). In addition we included a submodel into CLM-CN accounting for deforestation in the form of burning using past trajectories of land use change. Making use of advanced satellite data on area burnt the prognostic fire module for CLM-CN will be evaluated in terms of regional and interannual variability in fire emissions.

Kloster, S.; Thornton, P.; Randersson, J.; Mahowald, N.



HYPROM hydrology surface-runoff prognostic model  

NASA Astrophysics Data System (ADS)

The major objective of this study was to develop a hydrology model (HYPROM) to simulate overland watershed processes based on advanced numerical and parameterization methods. The resulting model, HYPROM, was designed for real-time watershed prediction. The model solves grid point-based shallow water equations with numerical approaches that include an efficient explicit time-differencing scheme for the gravity wave components and a physically based and numerically stable implicit scheme for the friction slope terms. The model dynamics (advection, diffusion, and height gradient force) are explicitly represented, whereas the model physics (e.g., friction slope) are parameterized, i.e., subgrid effects are expressed in terms of the model grid point variables. The fact that the modeling governing equations for momentum and mass are all prognostic makes HYPROM distinct to most other prognostic hydrology systems. The model uses real topography, river routing, and land cover data to represent surface influences. The HYPROM calculations can be executed offline (i.e., independent of a driving atmospheric model) or online as a callable routine of a driving atmospheric model. The model is applicable across a broad range of spatial scales ranging from local to regional and global scales. The model can be set up over different geographic domains and can run efficiently on conventional computer platforms. Finally, the model can be used either for hydrologic forecasts or climate studies if embedded as a component of an atmospheric climate model.

Nickovic, Slobodan; Pejanovic, Goran; Djurdjevic, Vladimir; Roskar, Jozef; Vujadinovic, Mirjam



Electronic prognostics - A case study using global positioning system (GPS)  

Microsoft Academic Search

Prognostic health management (PHM) of electronic systems presents challenges traditionally viewed as either insurmountable or otherwise not worth the cost of pursuit. Recent changes in weapons platform acquisition and support requirements has spurred renewed interest in electronics PHM, revealing possible applications, accessible data sources, and previously unexplored predictive techniques. The approach, development, and validation of electronic prognostics for a radio

Douglas W. Brown; Patrick W. Kalgren; Carl S. Byington; Michael J. Roemer



Electronic prognostics - a case study using Global Positioning System (GPS)  

Microsoft Academic Search

Prognostic health management (PHM) of electronic systems presents challenges traditionally viewed as either insurmountable or otherwise not worth the cost of pursuit. Recent changes in weapons platform acquisition and support requirements has spurred renewed interest in electronics PHM, revealing possible applications, accessible data sources, and previously unexplored predictive techniques. The approach, development, and validation of electronic prognostics for a radiofrequency

Douglas W. Brown; Patrick W. Kalgren; Carl S. Byington; Rolf F. Orsagh




EPA Science Inventory

Prognostic assessment provides information on environmental behavior of chemicals when no direct information exists. The utility of this method of analysis depends on the way in which the prognostic modeling tools are used. When the environment and the properties of the chemical ...


Prognostic Role of Brain Natriuretic Peptide in Acute Pulmonary Embolism  

Microsoft Academic Search

Background—Rapid, noninvasive, and accurate prognostic assessment with an inexpensive cardiac biomarker is an appealing approach for patients with acute pulmonary embolism (PE). Methods and Results—We measured at the time of admission the plasma level of plasma brain natriuretic peptide (BNP) to determine its utility in prognosticating the clinical course of 73 consecutive patients with acute PE. We used a prespecified

Nils Kucher; Gert Printzen; Samuel Z. Goldhaber



Mental Health and the Poor: Have the Gaps Between the Poor and the 'Non Poor' Narrowed in the Last Decade.  

National Technical Information Service (NTIS)

A study was conducted in Monroe County, New York, to evaluate the accessibility of mental health services to poor people between 1962 and 1971. Increases in the rate of psychiatric facility utilization were observed during the study period and were attrib...

B. M. Rosen



A comprehensive analysis of prognostic signatures reveals the high predictive capacity of the Proliferation, Immune response and RNA splicing modules in breast cancer  

PubMed Central

Introduction Several gene expression signatures have been proposed and demonstrated to be predictive of outcome in breast cancer. In the present article we address the following issues: Do these signatures perform similarly? Are there (common) molecular processes reported by these signatures? Can better prognostic predictors be constructed based on these identified molecular processes? Methods We performed a comprehensive analysis of the performance of nine gene expression signatures on seven different breast cancer datasets. To better characterize the functional processes associated with these signatures, we enlarged each signature by including all probes with a significant correlation to at least one of the genes in the original signature. The enrichment of functional groups was assessed using four ontology databases. Results The classification performance of the nine gene expression signatures is very similar in terms of assigning a sample to either a poor outcome group or a good outcome group. Nevertheless the concordance in classification at the sample level is low, with only 50% of the breast cancer samples classified in the same outcome group by all classifiers. The predictive accuracy decreases with the number of poor outcome assignments given to a sample. The best classification performance was obtained for the group of patients with only good outcome assignments. Enrichment analysis of the enlarged signatures revealed 11 functional modules with prognostic ability. The combination of the RNA-splicing and immune modules resulted in a classifier with high prognostic performance on an independent validation set. Conclusions The study revealed that the nine signatures perform similarly but exhibit a large degree of discordance in prognostic group assignment. Functional analyses indicate that proliferation is a common cellular process, but that other functional categories are also enriched and show independent prognostic ability. We provide new evidence of the potentially promising prognostic impact of immunity and RNA-splicing processes in breast cancer.

Reyal, Fabien; van Vliet, Martin H; Armstrong, Nicola J; Horlings, Hugo M; de Visser, Karin E; Kok, Marlen; Teschendorff, Andrew E; Mook, Stella; van 't Veer, Laura; Caldas, Carlos; Salmon, Remy J; Vijver, Marc J van de; Wessels, Lodewyk FA



Association of diarrhoea, poor hygiene and poor social conditions in childhood with blood pressure in adulthood  

Microsoft Academic Search

BackgroundPrevious research has suggested that dehydration in infancy may lead to high blood pressure in later life because of sodium retention. The purpose of this study was to examine the effect of poor hygiene of the child, poor social and poor housing conditions at home and diarrhoea in childhood as proxies for dehydration on high blood pressure in later life.MethodsData

L. Kauhanen; J. W. Lynch; H.-M. Lakka; J. Kauhanen; G. D. Smith



Does the Presence of Hypoechoic Lesions on Transrectal Ultrasound Suggest a Poor Prognosis for Patients With Localized Prostate Cancer?  

PubMed Central

Purpose The purpose of this study was to investigate the value of hypoechoic lesions on transrectal ultrasound (TRUS) as a prognostic factor for patients with localized prostate cancer. Materials and Methods The patients consisted of 71 patients with pT2N0M0 disease following radical prostatectomy between 2002 and 2008. The group with hypoechoic lesions was labeled group 1, whereas the group without hypoechoic lesions was labeled group 2. The presence of hypoechoic lesions on preoperative TRUS was analyzed as a prognostic factor along with several parameters, including preoperative factors and pathologic factors. The biochemical progression-free survival (BPFS) rate was compared between the two groups according to the presence of hypoechoic lesions on TRUS. Results A total of 35 patients had hypoechoic lesions on TRUS, whereas 36 had no hypoechoic lesions. Preoperative baseline characteristics were not significantly different between the two groups. In the univariate analysis, BPFS showed significant differences according to the presence of hypoechoic lesions on TRUS and the preoperative prostate-specific antigen level. The BPFS rates over the first 24 months were 97.0% in group 1 and 97.1% in group 2; however, the difference in the BPFS rate over 48 months significantly widened to 75.3% compared with 91.7%, respectively. Despite this finding, no significant independent prognostic factor for BPFS was found on multivariate analysis in this patient cohort. Conclusions The presence of hypoechoic lesions on TRUS may suggest worse prognostic characteristics in pT2 prostate cancer. Further studies involving larger subject populations are needed to corroborate the significance of the presence of hypoechoic lesions as a prognostic factor.

You, Hyun Wook; Jung, Sae Bin; Chang, Sung-Goo; Kim, Jin Il; Lim, Ju Won



First generation prognostic gene signatures for breast cancer predict both survival and chemotherapy sensitivity and identify overlapping patient populations.  


The aims of this study were to compare the performance of six different genomic prognostic markers to predict long-term survival and chemotherapy response on the same patient cohort and assess if clinicopathological variables carry independent prognostic and predictive values. We examined seven clinical variables and six previously described prognostic signatures on 228 tumors from patients who received homogeneous preoperative chemotherapy and had long-term follow-up information for survival. We used the area under the receiver operator characteristic curve (AUC) to compare predictors and also performed univariate and multivariate analyses including the genomic and clinical variables and plotted Kaplan-Meir survival curves. All genomic prognostic markers had statistically similar AUCs and sensitivity to predict 5-year progression-free survival (PFS, sensitivities ranged from 0.591 to 0.773, and AUCs: 0.599-0.673), overall survival (OS, sensitivities: 0.590-0.769, AUCs: 0.596-0.684) and pathologic complete response (pCR, sensitivities: 0.596-0.851, AUCs: 0.614-0.805). In multivariate analysis, the genomic markers were not independent from one another; however, estrogen receptor (Odds Ratio [OR] 7.63, P < 0.001) and HER2 status (OR: 0.37, P = 0.021) showed significant independent predictive values for pCR. Nodal status remained an independent prognostic, but not predictive, variable (OR for PFS: 2.77, P = 0.021, OR for OS: 3.62, P = 0.01). There was moderate to good agreement between different prediction results in pair-wise comparisons. First-generation prognostic-gene signatures predict both chemotherapy response and long-term survival. When multiple predictors are applied to the same case discordant risk prediction frequently occurs. PMID:21833625

Iwamoto, Takayuki; Lee, Ju-Seog; Bianchini, Giampaolo; Hubbard, Rebekah E; Young, Elliana; Matsuoka, Junji; Kim, Sang Bae; Symmans, W Fraser; Hortobagyi, Gabriel N; Pusztai, Lajos



Prognostic relevance of Ki-67 in the primary tumor for survival after a diagnosis of distant metastasis.  


Prediction of the prognosis for metastatic breast cancer patients depends on molecular subtypes similar to those found in patients with primary breast cancer. Several studies have shown that estrogen receptor (ER) and progesterone receptor (PR) status determine the course of the disease and the prognosis. As Ki-67 helps to differentiate molecular subtypes in patients with primary breast cancer, the aim of this study was to assess the prognostic relevance of Ki-67 in the primary tumor in relation to its prognostic relevance for patients with metastatic breast cancer. A total of 467 patients with invasive breast cancer were identified in the database of a single breast cancer center, in whom Ki-67 had been assessed in tumor material from the breast at the time of the primary diagnosis and who had developed a metastasis at any time during the subsequent course. For these patients, tumor and patient characteristics were used to determine prognostic factors relative to overall survival after the diagnosis of distant metastases. Ki-67 was added to this model to investigate whether this might improve the prediction of overall survival. In the multivariate Cox model, age at diagnosis, body mass index, nodal status, tumor size, ER and PR status, and time from diagnosis to metastasis were identified as relevant prognostic factors. Adding Ki-67 to the model improved the prediction of overall survival. There was also a significant and relevant interaction with the PR status. In patients with a low-proliferation primary tumor, a high level of PR expression would indicate an extraordinarily good prognosis (HR 0.39; 95 % CI, 0.23-0.66). In patients with higher-proliferation primary tumors, PR status was not capable of differentiating prognostic groups. Ki-67 is useful in addition to known prognostic factors for breast cancer. It is able to indicate a group of women with a poorer prognosis, specifically in the group of patients with PR-positive breast cancer. PMID:23479421

Loehberg, Christian R; Almstedt, Katrin; Jud, Sebastian M; Haeberle, Lothar; Fasching, Peter A; Hack, Carolin C; Lux, Michael P; Thiel, Falk C; Schrauder, Michael G; Brunner, Michaela; Bayer, Christian M; Hein, Alexander; Heusinger, Katharina; Heimrich, Jutta; Bani, Mayada R; Renner, Stefan P; Hartmann, Arndt; Beckmann, Matthias W; Wachter, David L



Prognostic Accuracy of Immunologic and Metabolic Markers for Type 1 Diabetes in a High-Risk Population  

PubMed Central

OBJECTIVE To establish and compare the prognostic accuracy of immunologic and metabolic markers in predicting onset of type 1 diabetes in those with high risk in a prospective study. RESEARCH DESIGN AND METHODS A total of 339 subjects from the Diabetes Prevention Trial–Type 1 (DPT-1) parenteral study, who were islet cell antibody (ICA)-positive, with low first-phase insulin response (FPIR) and/or abnormal glucose tolerance at baseline, were followed until clinical diabetes onset or study end (5-year follow-up). The prognostic performance of biomarkers was estimated using receiver operating characteristic (ROC) curve analysis and compared with nonparametric testing of ROC curve areas. Pearson correlation was used to assess the relationship between the markers. RESULTS Individually, insulin autoantibody titer, ICA512A titer, peak C-peptide, 2-h glucose, FPIR, and FPIR/homeostasis model assessment of insulin resistance provided modest but significant prognostic values for 5-year risk with a similar level of area under ROC curve ranging between 0.61 and 0.67. The combination of 2-h glucose, peak C-peptide, and area under the curve C-peptide significantly improved the prognostic accuracy compared with any solitary index (P < 0.05) with an area under ROC curve of 0.76 (95% CI 0.70–0.81). The addition of antibody titers and/or intravenous glucose tolerance test (IVGTT) markers did not increase the prognostic accuracy further (P = 0.46 and P = 0.66, respectively). CONCLUSIONS The combination of metabolic markers derived from the oral glucose tolerance test improved accuracy in predicting progression to type 1 diabetes in a population with ICA positivity and abnormal metabolism. The results indicate that the autoimmune activity may not alter the risk of type 1 diabetes after metabolic function has deteriorated. Future intervention trials may consider eliminating IVGTT measurements as an effective cost-reduction strategy for prognostic purposes.

Xu, Ping; Beam, Craig A.; Cuthbertson, David; Sosenko, Jay M.; Skyler, Jay S.; Krischer, Jeffrey P.



Important prognostic factors for the long-term survival of lung cancer subjects in Taiwan  

PubMed Central

Background This study used a large-scale cancer database in determination of prognostic factors for the survival of lung cancer subjects in Taiwan. Methods Total of 24,910 subjects diagnosed with lung cancer was analysed. Survival estimates by Kaplan-Meier methods. Cox proportional-hazards model estimated the death risk (hazard ratio (HR)) for various prognostic factors. Results The prognostic indicators associated with a higher risk of lung cancer deaths are male gender (males versus females; HR = 1.07, 95% confidence intervals (CI): 1.03–1.11), males diagnosed in later periods (shown in 1991–1994 versus 1987–1990; HR = 1.13), older age at diagnosis, large cell carcinoma (LCC)/small cell carcinoma (SCC), and supportive care therapy over chemotherapy. The overall 5-year survival rate for lung cancer death was significantly poorer for males (21.3%) than females (23.6%). Subjects with squamous cell carcinoma (SQCC) and treatment by surgical resection alone had better prognosis. We find surgical resections to markedly increase 5-year survival rate from LCC, decreased risk of death from LCC, and no improved survival from SCC. Conclusion Gender and clinical characteristics (i.e. diagnostic period, diagnostic age, histological type and treatment modality) play important roles in determining lung cancer survival.

Chiang, Tai-An; Chen, Ping-Ho; Wu, Pei-Fen; Wang, Tsu-Nai; Chang, Po-Ya; Ko, Albert Min-Shan; Huang, Ming-Shyan; Ko, Ying-Chin



Brain Metastases From Breast Carcinoma: Validation of the Radiation Therapy Oncology Group Recursive Partitioning Analysis Classification and Proposition of a New Prognostic Score  

SciTech Connect

Purpose: To validate the Radiation Therapy Oncology Group Recursive Partitioning Analysis (RTOG RPA) classification and determine independent prognostic factors, to create a simple and specific prognostic score for patients with brain metastases (BM) from breast carcinoma treated with whole-brain radiotherapy (WBRT). Methods and Materials: From January 1998 through December 2003, 132 patients with BM from breast carcinoma were treated with WBRT. We analyzed several potential predictors of survival after WBRT: age, Karnofsky performance status, RTOG-RPA class, number of BM, presence and site of other systemic metastases, interval between primary tumor and BM, tumor hormone receptor (HR) status, lymphocyte count, and HER-2 overexpression. Results: A total of 117 patients received exclusive WBRT and were analyzed. Median survival with BM was 5 months. One-year and 2-year survival rates were 27.6% (95% confidence interval [CI] 19.9-36.8%) and 12% (95% CI 6.5-21.2%), respectively. In multivariate analysis, RTOG RPA Class III, lymphopenia ({<=}0.7 x 10{sup 9}/L) and HR negative status were independent prognostic factors for poor survival. We constructed a three-factor prognostic scoring system that predicts 6-month and 1-year rates of overall survival in the range of 76.1-29.5% (p = 0.00033) and 60.9-15.9% (p = 0.0011), respectively, with median survival of 15 months, 5 months, or 3 months for patients with none, one, or more than one adverse prognostic factor(s), respectively. Conclusions: This study confirms the prognostic value of the RTOG RPA classification, lymphopenia, and tumor HR status, which can be used to form a prognostic score for patients with BM from breast carcinoma.

Le Scodan, Romuald [Department of Radiation Oncology, Centre Rene Huguenin, Saint Cloud (France)], E-mail:; Massard, Christophe [Department of Radiation Oncology, Centre Rene Huguenin, Saint Cloud (France); Mouret-Fourme, Emmanuelle [Department of Medical Statistics, Centre Rene Huguenin, Saint Cloud (France); Guinebretierre, Jean Marc [Department of Pathology, Centre Rene Huguenin, Saint Cloud (France); Cohen-Solal, Christine; De Lalande, Brigitte; Moisson, Patricia; Breton-Callu, Christelle; Gardner, Miriam [Department of Radiation Oncology, Centre Rene Huguenin, Saint Cloud (France); Goupil, Alain [Department of Medical Oncology, Centre Rene Huguenin, Saint Cloud (France); Renody, Nicole; Floiras, Jean Louis; Labib, Alain [Department of Radiation Oncology, Centre Rene Huguenin, Saint Cloud (France)



Predicting stabilizing treatment outcomes for complex posttraumatic stress disorder and dissociative identity disorder: an expertise-based prognostic model.  


The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity. PMID:21240739

Baars, Erik W; van der Hart, Onno; Nijenhuis, Ellert R S; Chu, James A; Glas, Gerrit; Draijer, Nel



Montreal prognostic score: estimating survival of patients with non-small cell lung cancer using clinical biomarkers.  


Background:For evidence-based medical practice, well-defined risk scoring systems are essential to identify patients with a poor prognosis. The objective of this study was to develop a prognostic score, the Montreal prognostic score (MPS), to improve prognostication of patients with incurable non-small cell lung cancer (NSCLC) in everyday practice.Methods:A training cohort (TC) and a confirmatory cohort (CC) of newly diagnosed patients with NSCLC planning to receive chemotherapy were used to develop the MPS. Stage and clinically available biomarkers were entered into a Cox model and risk weights were estimated. C-statistics were used to test the accuracy.Results:The TC consisted of 258 patients and the CC consisted of 433 patients. Montreal prognostic score classified patients into three distinct groups with median survivals of 2.5 months (95% confidence interval (CI): 1.8, 4.2), 8.2 months (95% CI: 7.0, 9.4) and 18.2 months (95% CI: 14.0, 27.5), respectively (log-rank, P<0.001). Overall, the C-statistics were 0.691 (95% CI: 0.685, 0.697) for the TC and 0.665 (95% CI: 0.661, 0.670) for the CC.Conclusion:The MPS, by classifying patients into three well-defined prognostic groups, provides valuable information, which physicians could use to better inform their patients about treatment options, especially the best timing to involve palliative care teams. PMID:24064979

Gagnon, B; Agulnik, J S; Gioulbasanis, I; Kasymjanova, G; Morris, D; Macdonald, N



Hepatic Resection for Metastatic Colorectal Adenocarcinoma: A Proposal of a Prognostic Scoring System  

PubMed Central

Background Hepatic resection for metastatic colorectal cancer provides excellent longterm results in a substantial proportion of patients. Although various prognostic risk factors have been identified, there has been no dependable staging or prognostic scoring system for metastatic hepatic tumors. Study Design Various clinical and pathologic risk factors were examined in 305 consecutive patients who underwent primary hepatic resections for metastatic colorectal cancer. Survival rates were estimated by the Cox proportional hazards model using the equation: S(t) = [So(t)]exp(R?Ro), where So(t) is the survival rate of patients with none of the identified risk factors and Ro=0. Results Preliminary multivariate analysis revealed that independently significant negative prognosticators were: (1) positive surgical margins, (2) extrahepatic tumor involvement including the lymph node(s), (3) tumor number of three or more, (4) bilobar tumors, and (5) time from treatment of the primary tumor to hepatic recurrence of 30 months or less. Because the survival rates of the 62 patients with positive margins or extra-hepatic tumor were uniformly very poor, multivariate analysis was repeated in the remaining 243 patients who did not have these lethal risk factors. The reanalysis revealed that independently significant poor prognosticators were: (1) tumor number of three or more, (2) tumor size greater than 8cm, (3) time to hepatic recurrence of 30 months or less, and (4) bilobar tumors. Risk scores (R) for tumor recurrence of the culled cohort (n = 243) were calculated by summation of coefficients from the multivariate analysis and were divided into five groups: grade 1, no risk factors (R = 0); grade 2, one risk factor (R = 0.3 to 0.7); grade 3, two risk factors (R = 0.7 to 1.1); grade 4, three risk factors (R = 1.2 to 1.6); and grade 5, four risk factors (R > 1.6). Grade 6 consisted of the 62 culled patients with positive margins or extrahepatic tumor. Kaplan-Meier and Cox proportional hazards estimated 5-year survival rates of grade 1 to 6 patients were 48.3% and 48.3%, 36.6% and 33.7%, 19.9% and 17.9%, 11.9% and 6.4%, 0% and 1.1 %, and 0% and 0%, respectively (p < 0.0001). Conclusions The proposed risk-score grading predicted the survival differences extremely well. Estimated survival as determined by the Cox proportional hazards model was similar to that determined by the Kaplan-Meier method. Verification and further improvements of the proposed system are awaited by other centers or international collaborative studies. (J Am Coll Surg 1999;189:291–299.

Iwatsuki, Shunzaburo; Dvorchik, Igor; Madariaga, Juan R; Marsh, J Wallis; Dodson, Forrest; Bonham, Andrew C; Geller, David A; Gayowski, Timothy J; Fung, John J; Starzl, Thomas E



Impact of the degree of anemia on the outcome of patients with myelodysplastic syndrome and its integration into the WHO classification-based Prognostic Scoring System (WPSS)  

PubMed Central

Background Anemia is an established negative prognostic factor in myelodysplastic syndromes but the relationship between its degree and clinical outcome is poorly defined. We, therefore, studied the relationship between severity of anemia and outcome in myelodysplastic syndrome patients. Design and Methods We studied 840 consecutive patients diagnosed with myelodysplastic syndromes at the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, and 504 patients seen at the Heinrich-Heine-University Hospital, Düsseldorf, Germany. Hemoglobin levels were monitored longitudinally and analyzed by means of time-dependent Cox’s proportional hazards regression models. Results Hemoglobin levels lower than 9 g/dL in males (HR 5.56, P=0.018) and 8 g/dL in females (HR=5.35, P=0.026) were independently related to reduced overall survival, higher risk of non-leukemic death and cardiac death (P<0.001). Severe anemia, defined as hemoglobin below these thresholds, was found to be as effective as transfusion-dependency in the prognostic assessment. After integrating this definition of severe anemia into the WHO classification-based Prognostic Scoring System, time-dependent regression and landmark analyses showed that the refined model was able to identify risk groups with different survivals at any time during follow up. Conclusions Accounting for severity of anemia through the WHO classification-based Prognostic Scoring System provides an objective criterion for prognostic assessment and implementation of risk-adapted treatment strategies in myelodysplastic syndrome patients.

Malcovati, Luca; Della Porta, Matteo G.; Strupp, Corinna; Ambaglio, Ilaria; Kuendgen, Andrea; Nachtkamp, Kathrin; Travaglino, Erica; Invernizzi, Rosangela; Pascutto, Cristiana; Lazzarino, Mario; Germing, Ulrich; Cazzola, Mario



From Many Lands. Voices of the Poor.  

ERIC Educational Resources Information Center

|This book, the last volume in a three-part series, draws on a large-scale worldwide poverty study to present the views, experiences, and aspirations of poor people in 14 selected countries. In each country, interviews and discussion groups were held in 8-15 rural and urban communities that reflected the most prevalent poverty groups and the…

Narayan, Deepa, Ed.; Petesch, Patti, Ed.


Is the human pharynx poorly designed?  

Microsoft Academic Search

he entire dysteleology argument is based on the recurrent assertion that there exist many examples of poor design in the human body. As knowledge of life improves, dysteleology claims have likewise been correspondingly disproved. The argument from dysteleology is not scientific support for evolution, but, instead, is a claim about the Creator's attributes—what some people believe that God would or

Jerry Bergman


The poorly explored impact of uncontrolled asthma.  


The goal of asthma management is to achieve disease control; however, despite the availability of effective and safe medications, for many patients asthma remains uncontrolled. One reason for this is the fear of long-term side effects from the regular use of inhaled corticosteroids (ICSs). Adverse effects of poorly controlled asthma (for example, obesity, pneumonia, and risks to the fetus) can be perceived as side effects of ICSs. Poorly controlled asthma adversely affects children's cardiovascular fitness, while children with well-controlled asthma perform at the same level as their peers. Children with uncontrolled asthma also have a higher frequency of obesity than children with controlled asthma. Stress can affect asthma control, and children with poorly controlled asthma are more likely to have learning disabilities compared with those with good control. In adults, focused attention and concentration are negatively affected in patients with untreated asthma, and patients with asthma are at greater risk for depression. Also, poorly controlled asthma increases the risks of severe asthma exacerbations following upper respiratory and pneumococcal pulmonary infections. ICSs used to improve asthma control have been demonstrated to improve all of these outcomes. Lastly, the risks of uncontrolled asthma during pregnancy are substantially greater than the risks of recommended asthma medications. Treatments to maintain asthma control are the best approach to optimize maternal and fetal health in the pregnancies of women with asthma. The maintenance of asthma control has significant advantages to patients and greatly outweighs the potential risks of treatment side effects. PMID:23381316

O'Byrne, Paul M; Pedersen, Søren; Schatz, Michael; Thoren, Anders; Ekholm, Ella; Carlsson, Lars-Göran; Busse, William W



The Economics of Poverty in Poor Countries  

Microsoft Academic Search

This article examines the links that have recently been studied between poverty, high fertility and undernourishment, on the one hand, and degradation of the local environmental-resource base and civic disconnection, on the other, in poor countries. An account is offered of a number of pathways involving positive feed-backs that create poverty traps, into which certain identifiable groups of people in

Partha Dasgupta



Tackling HIV in resource poor countries  

Microsoft Academic Search

Despite recent proposals to expand access to antiretroviral treatment for people with HIV in resource poor settings, debate continues about the cost effectiveness of prevention and treatment strategies. This debate delays the urgent action needed to implement a comprehensive global AIDS strategy. To underscore the need to link prevention with treatment, we review the effect of HIV on economic and

J S Mukherjee; P E Farmer; D Niyizonkiza; L McCorkle; C Vanderwarker; P Teixeira; J Y Kim



Profile of the Working Poor, 2009.  

National Technical Information Service (NTIS)

In 2009, according to the Census Bureau, about 43.6 million people, or 14.3 percent of the Nations population, lived at or below the official poverty level.1 Although the poor were primarily children and adults who had not participated in the labor force ...



Profile of the Working Poor, 2011.  

National Technical Information Service (NTIS)

TThe working poor 'are persons who spent at least 27 weeks (in the past year) in the labor force (that is, working or looking for work), but whose incomes fell below the official poverty level.' In other words, if someone spent more than half of the past ...



Profile of the Working Poor, 2010.  

National Technical Information Service (NTIS)

The working poor 'are persons who spent at least 27 weeks (in the past year) in the labor force (that is, working or looking for work), but whose incomes fell below the official poverty level.' In other words, if someone spent more than half of the past y...



The Invisible Poor: Rural Youth in America.  

ERIC Educational Resources Information Center

This report summarizes demographic information about rural populations in the United States and discusses a variety of issues that are relevant to rural youth poverty. Although recent poverty rates for rural areas were higher than urban poverty rates, the media and political forces have almost completely neglected the rural poor. Extensive census…

Hodgkinson, Harold; Obarakpor, Anita Massey


Poor Chic: The Rational Consumption of Poverty  

Microsoft Academic Search

A discussion of Poor Chic, or an array of fads and fashions in popular culture that make recreational or stylish `fun' of poverty, or of traditional symbols of working class and underclass statuses, challenges the reductionism of the view that `lifestyle' consumption has displaced consumption as a means of expressing social status (e.g. race, class, and gender). It is argued

Karen Bettez Halnon




Microsoft Academic Search

We test the proposition that it is possible to train the economically vulnerable, working poor of inner cities to make entrepreneurial discoveries. We demonstrate the effective use of a model of constrained, systematic search. We employ an experimental design with a control group using the alertness approach recommended by received theory and a treatment group using systematic search. Our results




Poor, Rural Neighborhoods and Early School Achievement.  

ERIC Educational Resources Information Center

A study sought to identify the existence of neighborhood effects on school achievement that are independent of social class and family background among students from poor, rural neighborhoods. Ethnographic material yielded a concept of rural West Virginia neighborhoods in which residents expect their encounters to be friendly, informal, almost…

Bickel, Robert; Smith, Cynthia; Eagle, Teresa Hardman


The Farm Poor: Counted, Miscounted, or Discounted?  

ERIC Educational Resources Information Center

|According to the definition of the Social Security Administration, a family of four was considered "poor" when their total annual income was less than $3,000. In 1955, the Household Food Consumption Survey found that all families spent one-third of their annual income on food, regardless of place of residence and income level, and farmers…

Holmes, O. Wendell


Restricted electricity use among poor urban households  

Microsoft Academic Search

For a variety of reasons, this article argues, electricity must be seen by policy?makers in South Africa not as the sole provider of all future household energy needs, but rather as one component of an energy mix which includes such ‘transitional’ fuels as coal, gas and paraffin. The reasons for this are that electricity is expensive for poor households; it

Caroline White; Leslie Bank; Sean Jones; Monga Mehlwana




Microsoft Academic Search

Appalachians are residents in a region that includes 22 million people in 404 counties in 13 states between Southwestern New York and Mississippi. Central Appalachia includes the defined geographic area of West Virginia, and parts of Kentucky, Tennessee, Virginia, and Ohio where a higher proportion of the almost entirely White, largely rural population is poor. The Appalachian region has traditionally

Nicholas K. Iammarino


The Thermal Diffusivity of some Poor Conductors  

Microsoft Academic Search

Angström's method for measuring the thermal conductivity of metallic bars is applied to the determination of the thermal diffusivity of poor conductors of heat. Results are given for a number of building materials, and the values are compared with values obtained by computation from the primary thermal constants, where these are known.

N S Billington



Text Comprehension Strategy Instruction with Poor Readers.  

ERIC Educational Resources Information Center

|Investigates effects of teaching text-comprehension strategies to children with decoding and reading-comprehension problems and with a poor or normal listening ability. Finds no differential program effects for the two listening levels. Finds no stable evidence of transfer of comprehension strategy-training to standardized general listening and…

van den Bos, Kees P.; Brand-Gruwel, Saskia; Aarnoutse, Cor A. J.



Do Time Poor Individuals Pay More?  

Microsoft Academic Search

There is a rising number of concepts that try to describe the broad perception of time poverty. Though detailed time poverty analyses are available, still little is said about its impacts on the individual behaviour. Within this article, a possible new implication is analysed: The author tests whether time poor individuals compare less between prices as a result of their

Tim Rathjen



Runway hazard detection in poor visibility conditions  

NASA Astrophysics Data System (ADS)

More recently, research on enhancing the situational awareness of pilots, especially in poor visibility flight conditions, gains more and more interests. Since pilots may not be able to spot the runway clearly in poor visibility conditions, such as fog, smoke, haze or dim lighting conditions, aviation landing problem can occur due to the (unexpected) presence of objects on the runway. Complicated and trivial instruments, switches, bottoms, plus sudden happenings are enough for the pilots to take care of during landing approach. Therefore, an automatic hazard detection approach that combines non-linear Multi-scale Retinex (MSR) image enhancement, edge detection with basic edge pattern analysis, and image analysis is investigated. The effect of applying the enhancement method is to make the image of the runway almost independent from the poor atmospheric conditions. The following smart edge detection process extracts edge information, which can also reduce the storing space, the comparison and retrieval time, and the effect of sensor noise. After analyzing the features existing in the edge differences occurring in the runway area by digital image processing techniques, the existing potential hazard will be localized and labeled. Experimental results show that the proposed approach is effective in runway hazard detection in poor visibility conditions.

Jiang, Bo; Rahman, Zia-Ur



Obstructive Jaundice in Hepatocellular Carcinoma: Response after Percutaneous Transhepatic Biliary Drainage and Prognostic Factors  

SciTech Connect

Purpose: To evaluate the therapeutic effect of percutaneous transhepatic biliary drainage (PTBD) in patients with obstructive jaundice caused by biliary involvement of hepatocellular carcinomas (HCC) and to determine the prognostic factors. Methods: We retrospectively analyzed the data of 22 consecutive patients (M:F = 20:2, mean age 52.8 years).Inclusion criteria were the patient having obstructive jaundice caused by HCC that invaded the bile ducts and having at least 4 weeks of follow-up data after the PTBD. We defined 'good response' and 'poor response' as whether the level of total bilirubin decreased more than 50% in 4 weeks or not. Total bilirubin level (T-bil),Child-Pugh score and the location of biliary obstruction for the two groups were compared. In addition, the interval between clinical onset of jaundice and PTBD, the degree of parenchymal atrophy and the size of the primary tumor were compared. Results: Of the 22 patients, 13 (59.1%) showed good response. T-bil was significantly lower in the good response group than in the poor (14.2 {+-} 6 mg/dlvs 25.9 {+-} 13.8 mg/dl, p = .017). In the five patients with T-bil <10 mg/dl, four (80%) showed good response,while in nine patients with T-bil > 20 mg/dl, only three (33%)showed good response. Although statistically not significant, patients with Child score <10 showed better results [good response rate of 66.7% (12/18)] than patients with Child score ?10 [good response rate of 25% (1/4)]. Involvement of secondary confluence of the bile duct also served as a poor prognostic factor (p =0.235). The interval between clinical onset of jaundice and PTBD, the presence of parenchymal atrophy and the size of the tumor did not show significant effect. Conclusion: Early and effective biliary drainage might be necessary in this group of patients with limited hepatic function.

Lee, Joon Woo; Han, Joon Koo; Kim, Tae Kyoung; Choi, Byung Ihn; Park, Seong Ho; Ko, Young Hwan; Yoon, Chang Jin; Yeon, Kyung-Mo [Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744 (Korea, Republic of)



Upregulation of microRNA-375 is associated with poor prognosis in pediatric acute myeloid leukemia.  


A genome-wide serum miRNA expression analysis previously showed the upregulation of microRNA-375 (miR-375) in acute myeloid leukemia (AML) patients compared with healthy controls. The aim of this study was to investigate the expression patterns and the prognostic relevance of miR-375 in pediatric AML. Expression levels of miR-375 in bone marrow mononuclear cells were detected by real-time quantitative PCR in a cohort of 106 patients with newly diagnosed pediatric AML. Expression levels of miR-375 in the bone marrow of pediatric AML patients were significantly higher than those in normal controls (P < 0.001). Then, miR-375 upregulation occurred more frequently in French-American-British classification subtype M7 than in other subtypes (P < 0.001). Regarding to cytogenetic risk, the expression levels of miR-375 in pediatric AML patients with unfavorable karyotypes were dramatically higher than those in intermediate and favorable groups (P = 0.002). Moreover, high miR-375 expression was significantly associated with shorter relapse-free survival (P < 0.001) and overall survival (P < 0.001) in pediatric AML patients. Multivariate analysis further identified miR-375 expression and cytogenetics risk as independent prognostic factors for both relapse-free survival and overall survival. In particular, the prognostic relevance of miR-375 expression was more obvious in the subgroup of patients with intermediate-risk cytogenetics. Our findings suggest for the first time that the upregulation of miR-375 may be one of the molecular mechanisms involved in the development and progression of pediatric AML. Since its correlation with poor relapse-free survival and overall survival, miR-375 may be a novel biomarker to improve the management of pediatric AML patients. PMID:23864342

Wang, Zhengyan; Hong, Ze; Gao, Feng; Feng, Weijing



DEK over expression as an independent biomarker for poor prognosis in colorectal cancer  

PubMed Central

Background The DEK protein is related to chromatin reconstruction and gene transcription, and plays an important role in cell apoptosis. High expression levels of the human DEK gene have been correlated with numerous human malignancies. This study explores the roles of DEK in tumor progression and as a prognostic determinant of colorectal cancer. Methods Colorectal cancer specimens from 109 patients with strict follow-up, and colorectal adenomas from 52 patients were selected for analysis of DEK protein by immunohistochemistry. The correlations between DEK over expression and the clinicopathological features of colorectal cancers were evaluated by Chi-square test and Fisher’s exact tests. The survival rates were calculated by the Kaplan-Meier method, and the relationship between prognostic factors and patient survival was also analyzed by the Cox proportional hazard models. Results DEK protein showed a nuclear immunohistochemical staining pattern in colorectal cancers. The strongly positive rate of DEK protein was 48.62% (53/109) in colorectal cancers, which was significantly higher than that in either adjacent normal colon mucosa (9.17%, 10/109) or colorectal adenomas (13.46%, 7/52). DEK over expression in colorectal cancers was positively correlated with tumor size, grade, lymph node metastasis, serosal invasion, late stage, and disease-free survival- and 5-year survival rates. Further analysis showed that patients with late stage colorectal cancer and high DEK expression had worse survival rates than those with low DEK expression. Moreover, multivariate analysis showed high DEK expression, serosal invasion, and late stage are significant independent risk factors for mortality in colorectal cancer. Conclusions DEK plays an important role in the progression of colorectal cancers and it is an independent poor prognostic factor of colorectal cancers.



Downregulation of microRNA-100 correlates with tumor progression and poor prognosis in hepatocellular carcinoma.  


Increasing evidence suggests that dysregulation of microRNAs is correlated with malignant transformation and tumor development. miR-100, a potential tumor suppressor, is downregulated by many human cancers. However, the expression and functions of miR-100 in hepatocellular carcinoma (HCC) are still unclear. The aim of this study was to detect the expression of miR-100 in HCC tissues and investigate its clinicopathological and prognostic significance. Also, the effects of miR-100 on growth and apoptosis of HCC cells and its potential molecular mechanisms were analyzed. Results showed that the expression level of miR-100 in HCC tissues was significantly lower than that in matched non-cancerous liver tissues. Also, low-miR-100 expression was observed to be significantly correlated with higher tumor grade, higher incidence of lymph node metastasis, advanced TNM stage and higher incidence of tumor recurrence in HCC patients. Multivariate survival analyses suggested that low-miR-100 expression was an independent prognostic factor for HCC patients (HR = 1.66, 95 % CI 1.32-2.82, P = 0.019). In addition, we found that upregulation of miR-100 could inhibit growth and increase apoptosis of HCC cells by downregulating polo-like kinase 1 (plk1). In HCC tissues, miR-100 expression was inversely correlated with the expression of plk1 protein (r = -0.418; P = 0.029). Therefore, downregulation of miR-100 was correlated with progressive pathological feature and poor prognosis in HCC patients, and miR-100 could function as a tumor suppressor by targeting plk1. miR-100 may serve as a prognostic marker and molecular therapeutic target in HCC. PMID:23842624

Chen, Ping; Zhao, Xia; Ma, Liang



Cutaneous extramedullary plasmacytoma: clinical, prognostic, and interphase cytogenetic analysis.  


Extramedullary plasmacytoma (EMP) of the skin is a rare indolent neoplasm that shares morphological and immunophenotypic features with plasma cell myeloma (PCM), but the molecular features that distinguish these two entities have not been defined. We reviewed the clinical characteristics, course, and molecular abnormalities in 7 cases of cutaneous EMP (cEMP); 2 patients had primary cEMP and 5 had secondary cEMP. Two patients died of progressive extramedullary plasmacytoma, 1 without PCM; 1 patient who had only a hyperdiploid clone, died within 17 months of the diagnosis of cEMP; and 3 died of PCM. One patient, who had cEMP with a hyperdiploid clone and a 13q deletion, was alive 28 months after diagnosis. Our findings raise questions about the relative prognostic value of molecular aberrations observed in cEMP and PCM. The role of fluorescence in situ hybridization testing in predicting disease progression of cEMP remains to be defined. PMID:23000906

Comfere, Nneka I; Gonzalez Santiago, Tania M; Peters, Margot S; Knudson, Ryan A; Ketterling, Rhett P; Gibson, Lawrence E



Titrated oxygen requirement and prognostication in idiopathic pulmonary fibrosis  

PubMed Central

Background The supplemental oxygen flow rate is a common bedside measure of gas exchange impairment. We aimed to determine whether a titrated oxygen requirement predicted mortality in idiopathic pulmonary fibrosis. Methods We examined 104 adults with idiopathic pulmonary fibrosis enrolled in a prospective cohort study and a validation cohort of 151 adults with a variety of interstitial lung diseases. The titrated oxygen requirement was defined as the lowest oxygen flow rate required to maintain an oxyhemoglobin saturation of 96% while standing. Cox proportional hazards models and time-dependent receiver operating characteristic curves were used to examine survival time. Results A higher titrated oxygen requirement was associated with a greater mortality rate independent of forced vital capacity and six-minute walk test results in idiopathic pulmonary fibrosis (adjusted hazard ratio per 1 L/min = 1.10, 95% confidence interval 1.01 to 1.20). The titrated oxygen requirement was at least as accurate as pulmonary function and six-minute walk testing at predicting 1-year mortality. Findings were similar in other interstitial lung diseases. Conclusion The titrated oxygen requirement is a simple, inexpensive bedside measurement that aids prognostication in idiopathic pulmonary fibrosis.

Hook, Jaime L.; Arcasoy, Selim M.; Zemmel, David; Bartels, Matthew; Kawut, Steven M.; Lederer, David J.



Molecular profiling reveals prognostically significant subtypes of canine lymphoma.  


We performed genomewide gene expression analysis of 35 samples representing 6 common histologic subtypes of canine lymphoma and bioinformatics analyses to define their molecular characteristics. Three major groups were defined on the basis of gene expression profiles: (1) low-grade T-cell lymphoma, composed entirely by T-zone lymphoma; (2) high-grade T-cell lymphoma, consisting of lymphoblastic T-cell lymphoma and peripheral T-cell lymphoma not otherwise specified; and (3) B-cell lymphoma, consisting of marginal B-cell lymphoma, diffuse large B-cell lymphoma, and Burkitt lymphoma. Interspecies comparative analyses of gene expression profiles also showed that marginal B-cell lymphoma and diffuse large B-cell lymphoma in dogs and humans might represent a continuum of disease with similar drivers. The classification of these diverse tumors into 3 subgroups was prognostically significant, as the groups were directly correlated with event-free survival. Finally, we developed a benchtop diagnostic test based on expression of 4 genes that can robustly classify canine lymphomas into one of these 3 subgroups, enabling a direct clinical application for our results. PMID:23125145

Frantz, A M; Sarver, A L; Ito, D; Phang, T L; Karimpour-Fard, A; Scott, M C; Valli, V E O; Lindblad-Toh, K; Burgess, K E; Husbands, B D; Henson, M S; Borgatti, A; Kisseberth, W C; Hunter, L E; Breen, M; O'Brien, T D; Modiano, J F



The prognostic significance of vanillylmandellic acid in neuroblastoma.  


The objective of this study was to evaluate urinary vanillylmandellic acid (VMA) as a marker for prognosis and progression of neuroblastoma. A retrospective file search of 444 patients during 33 years was performed and correlation of VMA with clinical prognostic parameters and outcome was evaluated. Event-free survivals (EFS) were 33.5% and 21% (P = .04) and overall survival (OS) were 36.6% and 25.8% (P = .1) for all patients with normal/negative and increased/positive VMA. EFS and OS were higher in VMA(-) pelvic (P = .03) and thoracic and neck (P = .04) tumors, compared to their VMA(+) counterparts. Survival was not different in patients with abdominal primaries according to VMA status. Positive urinary VMA prevalence was low in localized disease and high in disseminated disease (P < .001). In disseminated disease, 10-year EFS was higher in VMA(+) patients than VMA(-) patients (16%, 9.5%, P = .054). Two-year OS was higher in VMA-positive patients with stage 4 di