ABSTRACT
Objective To study the effect of multi-disciplinary team (MDT) management on the outcome in neonates with omphalocele.Method A retrospective non-randomized controlled clinical study was conducted.Neonates who were diagnosed as omphalocele and admitted to the surgical neonatal intensive care unit of the Guangzhou Women and Children Medical Center from December 2010 to December 2017 were collected.Because MDT was established in December 2014,infants were assigned into non-MDT group and MDT group according to their dates of admission.The characteristics and outcomes between non-MDT group and MDT group were compared using x2,t-test or rank-sum test.Multivariate analysis was performed by Logistic regression.Result A total of 91 neonates were included in the study,50 were in non-MDT group and 41 were in MDT group.The mortality in MDT group (2.4％,1/41) was lower than that in non-MDT group (18.0％,9/50),the difference was statistically significant (P ＜ 0.05).The median time of mechanical ventilation of giant omphalocele in non-MDT group (18.3 hours) was longer than that in MDT group (41.7 hours),the difference was also statistically significant (P ＜ 0.05).After adjusting for the associated confounding risk factors,the risk of death in non-MDT group was 54 times higher than that in MDTgroup (OR=54.19,95％CI2.64 ～1 113.49,P＜0.05).Conclusion There was significant association between the MDT management and the decreased risk of death of omphalocele.
ABSTRACT
Objective@#To investigate the expression differences of serum tumor markers, such as CEA, CA125 and CA15-3, in different molecular subtypes of breast cancer and their correlations with recurrence and metastasis. @*Methods@#The medical records and follow-up data from 212 patients with breast cancer were retrospectively analyzed. According to the expression of hormone receptor, breast cancer were divided into four molecular subtypes: Luminal A, Luminal B, Her-2 overexpression and Basal-like. The clinical characteristics and levels of CEA, CA125 and CA15-3 in different molecular subtypes of breast cancer patients before operation were compared, and the factors influencing the recurrence and metastasis of breast cancer were analyzed. @*Results@#There were differences in the expression levels of tumor markers for different molecular subtypes of breast cancer. The expression levels of CA15-3 in patients with Her-2 overexpression were significantly higher than that with Luminal A, Luminal B or Basal-like (χ 2 =7.98,P=0. 04). The differentiation degree of tumor cells in different molecular subtypes of breast cancer was different, and the proportion of low differentiation in the patients with Her-2 overexpression was significantly higher than that with Luminal A, Luminal B or Basal-like (χ 2 =12.42,P=0.006). There was also differences in the recurrence and metastasis of tumor for 4 subtypes of breast cancer, and the highest recurrence and metastasis rate existed in the patients with Her-2 overexpression (F=8.69,P=0.034). The multivariate Cox regression analysis showed that tumor diameter, degree of tissue differentiation and presence or absence of vascular tumor thrombus were independent risk factors for the recurrence and metastasis of breast cancer patients (all P＜0.05). @*Conclusion@#The breast cancer patients with Her-2 overexpression have high levels of CA15-3 and poor prognosis, which suggests that the individualized treatment of breast cancer should be combined with molecular subtyping, tumor markers and related risk factors.