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BACKGROUND@#The expression of programmed cell death ligand 1 (PD-L1) as a biomarker for immunotherapy in non-small cell lung cancer (NSCLC) is routinely detected in clinical pathology department. However, the spatial heterogeneity of PD-L1 expression in intrapulmonary tumors and extrapulmonary metastases is still a challenge for the clinical testing. This study aims to explore the differences of PD-L1 expression in test samples obtaining from different sites of NSCLC. This study may contribute to the detection strategy of PD-L1 in patients with advanced lung cancer.@*METHODS@#One hundred and thirty-one cases of consecutively detected PD-L1 (22c3 assay, Dako) staining in metastatic NSCLC and 972 cases of non-paired intrapulmonary NSCLC were collected. The discrepancies of tumor proportion score (TPS) of PD-L1 expression in intrapulmonary samples and extrapulmonary metastatic samples of different sites were compared.@*RESULTS@#The positive expression rate of PD-L1 in extrapulmonary metastatic NSCLC (TPS ≥ 1%) was 61.83%, and the TPS was significantly higher than that in intrapulmonary tumors (P=0.03). The PD-L1 scores of the specimens obtained from different sites were significantly different (P=0.007). The positive rates of PD-L1 in liver and adrenal metastases were 85.71% and 77.78% respectively, and their TPS were significantly higher than that of the intrapulmonary samples (P<0.05). The positive rates of PD-L1 in lymph node, bone, brain, soft tissue, and pleural metastases was 40.00%-66.67%, with no significant differences compared to intrapulmonary tumors. The analysis of histological subtype and sample type showed that the PD-L1 score of extrapulmonary samples of adenocarcinoma subtype or surgical specimen was significantly higher than that of intrapulmonary tumors. The analysis of clinicopathological parameters showed that the PD-L1 positive expression or high expression were significantly correlated with male patients, smoking history, and epidermal growth factor receptor (EGFR) wild type.@*CONCLUSIONS@#The expression of PD-L1 in metastatic NSCLC is generally higher than that in intrapulmonary tumor, and the positive rate of PD-L1 expression was discrepant in different sites of specimen. The differences of PD-L1 score between extrapulmonary metastatic samples and intrapulmonary samples may be associated with different metastatic sites, histological subtype, and specimen type.
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Humans , Male , B7-H1 Antigen/metabolism , Biomarkers, Tumor/metabolism , Carcinoma, Non-Small-Cell Lung/drug therapy , Immunohistochemistry , Lung Neoplasms/drug therapyABSTRACT
Anticipatory grief is the grief that an individual feels about the imminent loss, which can cause adverse effects on the patient ,s family, such as psychology, physiology, and behavior. In order to fully understand the research progress of anticipated grief in the patient ,s family, this article starts with expectations. The concept of anticipatory grief, measurement tools, influencing factors, intervention programs, and study population are reviewed in order to provide references for the domestic research on anticipatory grief of patients , families.
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Objective:To investigate the clinicopathologic features and prognosis of breast mucosa associated lymphoid tissue(MALT) lymphoma.Methods:Clinical data of 8 breast MALT lymphoma patients were retrospectively analyzed at Tianjin Medical University Cancer Institute and Hospital from Jan 1, 2004 to Jan 31, 2017.Results:All were females, median age was 50 years. Tumors were located in the left breast in 3 cases while 5 cases in the right. All tumors were single in the outer-upper 1/4 quadrant of the breast. By Ann Arbor clinical stageⅠ, Ⅱ, Ⅲ and Ⅳ were 3, 2, 1 and 2, respectively. None of patients had B symptoms. 7 cases underwent surgery.All of the 8 cases received chemotherapy, 6 cases had complete response, one partial response, one with stable in efficacy evaluation. The follow-up time was 2-154 months. The 1, 3, 5-year overall survival rate were 100.0%, 50.0%, 50.0%, median survival time was 144.00 months. The 1-year progress free survival rate was 78.0% and median progress free survival time 28.29 months.Conclusion:Breast MALT is extremely rare without specific clinical features. Almost all are single tumors without B symptom. It′s sensitive to chemotherapy and the patients have fair prognosis.
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Objective:To explore the relationship between learning motivation and professional identity of nursing students.Methods:A total of 1 538 undergraduate and specialized nursing students from a medical college in Shandong Province were investigated with general information questionnaire, occupational identity scale and learning motivation scale.Results:The total score of professional identity and learning motivation of nursing students was 57.54±12.89 and 119.92 ±22.03 all of which were at the middle level. There was a positive correlation between the total score and each dimension ( r=0.225-0.614, P<0.01). Conclusions:Nursing students' professional identity is positively correlated with their learning motivation. The stronger their learning motivation is, the higher their level of professional identity is. It suggests that nursing education and managers should pay attention to improving their learning motivation and establish a stable professional concept.
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Objective:To observe the clinical effect of Shufeng Jiedu capsules combined with the conventional treatment on upper airway cough syndrome(UACS). Methods:Totally 55 patients with UACS and basic nasal or sinus diseases were randomly divided into two groups:the treatment group (n = 28) and the control group (n = 27). The treatment group was treated with Shufeng Jiedu capsules combined with the regimen for the control group,40 mg·kg-1,3 times a day, and the regimen for the control group was as follows:loratadine tablets, 10 mg,qd, budesonide nasal spray hormone 128 μg, bid, roxithromycin dispersible tablets,0.15 g,qd. The treatment course was 4 weeks. The changes of symptom scores were observed and the adverse reactions were recorded to compare the efficacy between the groups. Results:The total effective rate of the treatment group was 85.71%, which was significantly higher than that of the control group(75.37%,P <0.05). The cough and nasal symptoms were notably improved in the two groups after the treatment(P < 0.05),and all the symptom scores in the treatment group were better than those in the control group (P < 0.05). Conclusion:Shufeng Jiedu capsules combined with the conventional treatment can improve the efficacy in the treatment of UACS.
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Objective:The clinicopathological features, diagnosis, and prognosis of follicular thyroid carcinoma (FTC) with distant me-tastasis as the first manifestation were evaluated in this study. Methods:A total of 129 FTC cases with clinical data were retrospective-ly analyzed in the Department of Pathology, Tianjin Medical University Cancer Institute and Hospital (January 2001 to January 2016). Survival analysis and conjoint analysis on FTC with clinical data, diagnosis, and morphological characteristics with distant metastasis as the first manifestation were performed. Results:Among the 129 FTC cases, 24 cases demonstrated distant metastasis as the first mani-festation (18.6%). Bone metastasis was the most common (13.2%). The presence of mass and pain at the metastatic sites were the usu-al clinical complaints. The morphological characteristics of FTC with distant metastasis can be classified into four subtypes:microfollicu-lar (10 cases), solid (4 cases), normofollicular (9 cases), and macrofollicular (1 case). Immunostaining tests on thyroglobulin and thyroid transcription factor-1 showed positive results in FTC with metastasis. Survival analysis showed that the five-year survival rates in the 24 cases were 87.1%. The prognosis of patients with solitary metastasis was better than that of patients with multiple metastasis (P=0.022). A higher survival rate was found in the normofollicular and macrofollicular subtypes than that detected in the microfollicular and solid subtypes (P=0.012). Conclusion:FTC is susceptible to distant metastasis. Some patients with FTC demonstrated distant me-tastasis as the first manifestation, and their diagnosis can be confirmed by pathological feature analysis and immunostaining. The prog-nostic significance is possibly related to the number of lesions of FTC with distant metastasis and histopathological subtypes.
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Base on the data of blood pressure, plasma lipid, Glu and UA by physical test, Support Vector Machine (SVM) was applied to identify coronary heart disease (CHD) in patients and non-CHD individuals in south China population for guide of further prevention and treatment of the disease. Firstly, the SVM classifier was built using radial basis kernel function, liner kernel function and polynomial kernel function, respectively. Secondly, the SVM penalty factor C and kernel parameter sigma were optimized by particle swarm optimization (PSO) and then employed to diagnose and predict the CHD. By comparison with those from artificial neural network with the back propagation (BP) model, linear discriminant analysis, logistic regression method and non-optimized SVM, the overall results of our calculation demonstrated that the classification performance of optimized RBF-SVM model could be superior to other classifier algorithm with higher accuracy rate, sensitivity and specificity, which were 94.51%, 92.31% and 96.67%, respectively. So, it is well concluded that SVM could be used as a valid method for assisting diagnosis of CHD.