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Objective:To study the factors influencing survival after radical resection in patients with intrahepatic cholangiocarcinoma (ICC), and to construct a nomogram on survival prediction.Methods:The clinical data of 139 patients with ICC who underwent radical resection at the People's Hospital of Zhengzhou University from June 2018 to December 2021 were retrospectively analyzed. There are 69 males and 70 females, aged (59.5±10.2) years old. These patients were divided into two groups based on a 3: 1 ratio by using the random number method: the test group ( n=104) and the validation group ( n=35). Data from the test group was used to construct a nomagram and data from the validation group was used to validate the predictive power of the nomagram. Univariate and multivariate Cox regression analyses were used to analyse factors influencing survival on the test group patients and to construct a nomogram. The predictive accuracy of the nomogram was determined by receiver operating characteristic (ROC) curves, concordance index (C-index) and calibration curves. Results:The results of the multivariate regression analysis showed that a combined hemoglobin, albumin, lymphocyte and platelet immunoinflammation (HALP) score <37.1 ( HR=1.784, 95% CI: 1.047-3.040), CA19-9 > 35U/ml ( HR=2.352, 95% CI: 1.139-4.857), poorly differentiated tumor ( HR=2.475, 95% CI: 1.237-4.953) and vascular invasion ( HR=1.897, 95% CI: 1.110-3.244) were independent risk factors that affected prognosis of patients with ICC after radical resection (all P<0.05). The AUCs of the nomogram in the test group in predicting the overall survival at 1, 2 and 3 years of patients with ICC after radical resection were 0.808, 0.853 and 0.859, respectively. There was good consistency between the prediction of the nomogram and actual observation. The predicted C-index of the total survival period of the test group was 0.765 (95% CI: 0.704-0.826), and the C-index of the validation group was 0.759 (95% CI: 0.673-0.845). Conclusion:A HALP score <37.1, CA19-9>35 U/ml, poorly differentiated tumour and vascular invasion were independent risk factors for prognosis of ICC patients after radical resection. The nomogram was established based on the above factors and showed good performance in predicting overall survival after radical resection in patients with ICC.
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Objective To analyze the clinicopathological factors impacting on the prognosis of colorectal cancer liver metastases and to investigate how to improve patients' survival.Methods The clinical data of 103 patients who received radical resection for liver metastases from colorectal cancer from January 2005 to December 2011 were enrolled.The survival curve was drawn by Kaplan-Meier method,and the survival rates were analyzed by Log-rank test.Factors influencing survival were analyzed by Cox regression model.Results All patients were followed up from 10 to 60 months,The 1-,3-,5-year's survival rates were 90％,49％,39％,respectively.Univariate analysis revealed that number and size of liver metastases,distribution of liver metastases,serum CEA concentration,complications,postoperative chemotherapy were related to prognosis (x2 =24.732,9.461,9.568,25.948,25.370,5.701,P ＜ 0.05).Multivariate analysis identified number of liver metastases,serum CEA concentration,complications were as significant predictors of survival (Wald =7.974,12.051,11.547,P ＜ 0.05).Conclusions Number of liver metastases,serum CEA concentration,complication are important prognostic factors for liver metastases from colorectal cancer.Appropriate expansion of surgical indication,early diagnosis with intensive follow-up is crucial to increase the survival rate after hepatectomy for liver metastasis of coloractal carcinoma.
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Objective To investigate the expression of oncogene C-erbB-2 and its significance in colorectal carcinoma. Methods Immunohistological EnVision staining was used to detect the expression of C-erbB-2 in 171 colorectal carcinoma, and 15 normal colorectal tissues were taken as controls. Results The positive percentages of C-erbB-2 in colorectal carcinoma and normal colorectal tissues were 23.4 % (40/171)and 0, which was significantly different (P ＜0.05). Only 5 samples showed strong positive expression (++ and +++) on epicyte, no relationship was found between C-erbB-2 expression and patients' gender, tumor differentiation, tumor stage, vascular and lymph node involvement, etc(P ＞0.05). The five year survival rate were 69.5 % (91/131) and 65.0 % (26/40) of C-erbB-2 negative and positive expression, the difference was not statistical (P ＞0.05). Conclusion There was on significant association between C-erbB-2 expression and clinicopathologic characteristics of colorectal carcinoma. C-erbB-2 did not present prognostic value in colorectal carcinoma.
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BACKGROUND: Lung cancer keeps the first place in malignant tumor death all along. It is quite necessary to clarify the situation and tendency change of residents' lung cancer death for formulating prevention and cure strategy.OBJECTIVE: To investigate the lung cancer death characteristics, death trend and result out potential life loss of the residents in urban areas of Xuzhou.DESIGN: A retrospective descriptive epidemiology study.SETTING: Center for Disease Prevention and Control of Xuzhou.PARTICIPANTS: Totally 3 890 cases died of lung cancer between 1990 and 2003 in the urban areas of Xuzhou city. METHODS: Residents' lung cancer death characteristics and potential life span loss situation with parameters of crude death rate, standardized death rate, age specific death rate and potential life span loss and other indexes of the residents in the urban areas of Xuzhou city in 1990 and 2003were described.MAIN OUTCOME MEASURES: ①Crude death rate of lung cancer;②Potential life span loss; ③Life lost rate.RESULTS: ①During 14 years period , 3 890 cases of lung cancer death happened ,which accounted for 27.43% of total cases of malignant tumor death; ② year average death rate was 28.31/100 thousand, standardized death rate was 24.88/100 thousand, residents' potential life span loss caused by lung cancer death accounted for 24 230 people per year③ life decreasing rate was 1.19/1 000, standardized life decreasing rate was 1.45/1 000, each case of lung cancer death resulted in potential life loss of 6.23 years; males' death rate was higher than females'(x2=575.70,P ＜ 0.01), the ratio of male to female was 2.31:1. Age specific death rate of male and female after 20 years of age increased in an exponential manner.CONCLUSION: Lung cancer is the most serious malignant tumor that threatens the life health of residents in urban areas of Xuzhou city; the potential life span loss caused by lung cancer is very big. The amount of carcinogenic substances exposed in environments is closely related to the occurrence of lung cancer; therefore, prevention and control of lung cancer should be performed actively.
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<p><b>OBJECTIVE</b>To investigate the etiological agent of patients with diarrhea followed by acute kidney failure symptoms in China, 1999.</p><p><b>METHODS</b>Western blot was used to detect serum specific antibodies of patients against entero-haemorrhagic Escherichia coli hemolysin (EHEC-Hly) and lipo-polysaccharide of E. coli O157.</p><p><b>RESULTS</b>Twenty-one and 16 of 42 patients showed positive reaction of specific IgG or IgM antibodies against EHEC-Hly respectively. Eleven of 42 serum samples were positive for having both IgG and IgM antibodies while 26 of 42 samples were positive for IgG or IgM. For E. coli O157 LPS test, 24 and 24 of 42 samples showed positive for IgG or IgM antibodies respectively. In 42 samples, 20 were positive for IgG and IgM while 29 were positive for IgG or IgM.</p><p><b>CONCLUSIONS</b>Twenty-two of 42 samples were reacted with EHEC-Hly and E. coli O157 LPS, but 34 of 42 samples were positive for EHEC-Hly or E. coli O157. In combination of western blot results, bacterial isolation clinical symptoms and epidemiological investigation findings, it was reasonable to conclude that this cluster of patients with distinguish clinical symptoms was caused by E. coli O157:H7, which had never been reported in China. Hence serological methods with EHEC-Hly and E. coli O157 LPS are valuable for diagnosis of infections of E. coli O157:H7, when bacterial isolation is failed.</p>
Subject(s)
Adult , Aged , Humans , Middle Aged , Antibodies, Bacterial , Blood , Escherichia coli Infections , Allergy and Immunology , Escherichia coli O157 , Allergy and Immunology , Hemolysin Proteins , Allergy and Immunology , Hemolytic-Uremic Syndrome , Allergy and Immunology , Immunoglobulin G , Blood , Immunoglobulin M , Blood , Lipopolysaccharides , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the proportion of hemorrhagic colitis (HC) caused by Escherichia coli O157:H7 in bacterial diarrhea in Xuzhou city, Jiangsu province.</p><p><b>METHODS</b>All stool samples from patients with diarrhea were screened for O157 antigen, using Immuno-gold kits. Positive samples were cultured to detect the existence of pathogens. All of the HC patients confirmed by bacterial isolation and identification were investigated for clinical symptoms and laboratory tests.</p><p><b>RESULTS</b>Of the diarrhea patients identified in Feng county in May, and in Tongshan county of Xuzhou city in June 2000, Jiangsu province 0.98% and 5.89% were caused by Escherichia coli O157:H7 respectively, confirmed by bacteriological isolation and identification of stool samples. At the early phase of hemorrhagic colitis, 18.5% patients had at least one abnormal clinical laboratory test results including protein in urea and increased BUN or creatinine that indicating the possibility of kidney damage. In 27 strains of E. coli O157:H7 isolated from those patients, 13 and 14 were identified as Shiga toxin producing and Shiga-toxin negative E. coli O157:H7 (Stx-positive or Stx-negative) respectively. By analysis of the two groups of patients divided by according to the nature of Shiga toxin, four of 13 patients of Stx-positive group showed positive urea protein. However only 1 of the 13 patients of Stx-negative group was urea protein positive. The decreased Platelets counts were observed in 6 of 13 patients with Stx-positive group, but only in 1 of 14 patients with stx-negative group. These differences were statistically significant.</p><p><b>CONCLUSION</b>HC patients caused by E. coli O157:H7 were commonly seen (up to 5.89%) in Xuzhou city, Jiangsu province. Early laboratory tests should be conducted for HC patients as early as possible in order to find early indictor of kidney failure which was critical for prevention of hemolytic uremic syndrome.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Diarrhea , Escherichia coli Infections , Escherichia coli O157ABSTRACT
Background and purpose:Carcinoembryonic antigen(CEA) is mainly used in post-surveillance of colorectal cancer(CRC). Recently, bile CEA assay was reported to be of value in the diagnosis of OHM(occult hepatic metastasis) in CRC. We measured CEA levels in both peripheral vein and bile from patients with CRC to evaluate the change of bile CEA levels in patients with CRC and its relation to liver metastasis (LM). Methods:Three groups were enrolled in our study. Primary CRC Group: 27 patients with CRC but without LM; LM Group: 14 patients with LM from CRC; Control Group: 20 patients with benign biliary diseases (cholelithiasis or cholecystitis). Both serum and bile were collected to measure CEA levels in all groups but only bile CEA was measured in control group. Results:Bile CEA level in control group, primary CRC group and LM group were 1.73 ng/ml,13.7 ng/ml and314.27 ng/ml respectively, (P