ABSTRACT
Objective:To develop and validate an clinical prediction model for the risk of breast cancer-related lymphedema (BCRL).Methods:Breast cancer patients who were prepared to undergo axillary lymph node dissection were propsectively enrolled, indocyanine green combined with Photodynamic Eye (PDE) was applied to reveal the arm lymphatic flow . The arm lymphatic fluorescence images were collected to calculate the proportion of arm lymph flow above and below the axilla vein. Volumetric measurements of both arms and subjective questionnaire were performed to evaluate the occurrence of lymphedema. A difference in volume between the arms >10% was defined as lymphedema. Univariate logistic regression analysis was used to analyze the relationship between each factor and BCRL. The stepwise forward method was used to include multiple factors in the logistic regression analysis to establish the prediction model.Results:Three hundred and twelve patients were enrolled. Fourty-five (14.4%) patients developed BCRL. Using the coefficients obtained from multivariate analysis, BMI ( OR 95% CI: 1.34 (1.25-1.77), P<0.05), chemotherapy ( OR 95% CI: 2.26 (1.97-2.63), P<0.05), regional lymph node radiotherapy ( OR 95% CI: 1.59 (1.05-2.41), P<0.05) and the proportion of arm lymph flow above the level of the axillary vein ( OR 95% CI: 0.70 (0.68-0.81), P<0.05) were identified as independent predictive factors for BCRL, and the following prediction equation was derived: Y=0.369×(BMI at surgery)+0.713×(taxane-based chemotherapy)+0.862×(radiotherapy)-9.058×(proportion of the arm lymph above the axillary vein)-6.859 8. The ROC curve was screened to the optimal boundary value of 0.118 6 by the Youden's index. The sensitivity, specificity, positive predictive value and negative predictive value of prediction of this model were 93.3%, 79.4%, 73.3%, 98.6%, respectively. Conclusion:With the guidance of the predictive model, particular patients who need the preservation of axillary lymphatic system can be identified, and timely intervention can be carried out.
ABSTRACT
Objective To study the expression of Fibulin-5 in gastric cancer and its correlation with the prognosis of gastric cancer.Methods Tissue chips from 90 gastric cancer cases were used to study the expression of Fibulin-5 protein in cancer tissue and para-carcinoma tissue by immunohistochemistry,and analyze the correlation of Fibulin-5 expression and clinical pathological characteristics.Results The expression of Fibulin-5 in gastric cancer tissue was higher than that of para-carcinoma tissue [cytoplasm:(6.2±4.2) vs.(5.1 ±3.7);nucleus:(7.2 ±3.8) vs.(4.9 ±2.5),all P＜0.05],which was positively related with patient's age (r =0.213,P =0.044) in the cytoplasm of cancerous tissue.The expression of Fibulin-5 in the cytoplasm of cancerous tissue was negatively related with patient's overall survival (25％ vs.56％,P =0.027),which was an independent predictor (P =0.037).Conclusion Fibulin-5 is an independent prognostic factor of gastric cancer,its expression might be related with shortend patient's survival time.
ABSTRACT
Objective To analyze the association between C12 tumor markers and colorectal cancer,in order to screen for colorectal cancer related tumor markers so as to provide theoretical base for the establishment of colorectal cancer diagnostic biochips. Methods The sera of 173 colorectal cancer patients were detected for 12 common tumor markers including carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 242 (CA242), cancer antigen 15-3 (CA15-3), cancer antigen 125 (CA125), prostate specific antigen (PSA), free-PSA, neuron-specific enolase (NSE),human chorionic gonagotropin-beta (β-HCG), human growth hormone (HGH), and ferritin using the C12tumor markers proteinchip, and colorectal cancer related parameters were analyzed by Kappa test and cost-effectiveness analysis to find the most optimal tumor marker program. Results CEA (36.4 %), CA242(19.7 %), CA19-9 (18.5 %), CA125(9.8 %) were major tumor markers increased among the 173 colorectal cancer patients. Kappa test revealed 7 tumor marker programs having strong consistency with the detection results of C12 tumor markers proteinchip, and CEA singly detected was proved to be the best program by cost-effectiveness analysis. Conclusion C12 tumor markers proteinchip system have limited value in the diagnosis of colorectal cancer, but the design of chip is too complicated and costly for widespread screening among the high risk populations. Searching for new colorectal cancer biomarkers and designing small diagnostic chip could significantly enhance the clinical value of tumor markers in terms of diagnostic rate and practical utility.