ABSTRACT
Objective:To evaluate the effect of preoperative panel reactive antibody(PRA)levels on long-term survival after kidney transplantation. Methods:Data on 1 162 patients underwent first kidney transplantation performed between January 2001 and June 2014 were included in our center. According to the preoperative PRA levels,the patients were divided into negative group( PRA≤10%) and positive group( PRA>10%) ,which were retrospectively analyzed. Results: The 1-,5-,10-year patient survival rates of the negative group calculated by Kaplan-Meier were 96. 8%,89. 4%,78. 6%,respectively,while the positive group were 93. 5%,81. 6%, 65. 4%. The 1-,5-,10 -year death-censored graft survival rates of the negative group were 95. 9%,84. 8%,63. 1%,respectively,while the positive group were 92. 3%,74. 1%,51. 9%. The log-rank test revealed that there was significant difference between the patient and graft survival curves (χ2 =9. 623/11. 019, P=0. 002/0. 001 ) . Cox multivariate analysis found that preoperative PRA levels were independent risk factors for reducing the patient or graft survival rates(P<0. 001). Logistic multivariate regression analysis confirmed the significant association between preoperative PRA levels and the risk of acute rejection ( OR=8. 25,95% CI=2. 86-5. 72, P<0. 001). The 5-,10-year creatinine values were significantly lower in the negative group compared to the positive group(all P<0. 05), while there was no difference in the 1-year. In addition, Logistic multivariate regression analysis confirmed the significant association between preoperative PRA levels and the production of donor specific antibody(DSA)(OR=6. 89,95% CI=4. 52-9. 17,P<0. 05). Conclusion: The detection of preoperative PRA is an important indictor predicting the sensitivity status of the recipients. The preoperative PRA positive recipients need careful monitoring and diagnosis of acute rejection and DSA after kidney transplantation.
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Objective To study lymph node micrometastasis in N0 colorectal cancer patients and its clinical significance. Methods In this study, 548 lymph nodes obtained from 62 cases of No colorectal cancer undergoing curative operation were examined by fluorescent quantity polymerase chain reaction assay for the expression of cytokeratin 20 (CK20) mRNA. Results Micrometastasis was detected in 55 lymph nodes (10.0% ) of 24 cases (39%). According to lymph node anatomical locations, micrometastasis was identified in 15. 8%, 5.0% and 3.3% lymph nodes in group Ⅰ ,Ⅱ and Ⅲ (grouped by the distance from the tumor), respectively. Micrometastasis was correlated with invasion depth of primary tumor, but was notrelated to gender, age, tumor size, tumor site and differentiation. Conclusions The expression of CK20mRNA in lymph nodes in patients with No coloreetal cancer could be used to improve the accuracy of clinical staging, and provide information for rational adjuvant therapy.
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Objective To be investigated the morphology of colorectal small flat adenoma and the expressions of p53 , p21, ER and PR. Methods Colonoscopy ( Olympus CF 240) and microscopy ( Olympus BV 41) were used to observe 50 cases of colorectal small flat adenomas. The expressions of p53 , p21 , ER, and PR were detected by the two steps of immunohistochemistry in 50 cases of small flat adenomas and the surrounding mucosa, 26 cases of colorectal carcinomas, while 15 cases of the normal colorectal mucosa as control group. Results These lesions were distributed throughout the large bowel, the prevalence in order was transverse colon, sigmoid and rectum. The small flat adenoma was round, flat, or sessile in shape, and sized