ABSTRACT
Background and purpose: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is of advantage in treating non-small cell lung cancer (NSCLC) patients with EGFR mutations. However, their clinical effects vary individually. This study aimed to evaluate whether the EGFR ligand, plasma transforming growth factor α (TGF-α), could act as a predictor for the EGFR-TKI treatment e?ciency in NSCLC patients with EGFR mutations and the association between TGF-α and prognosis in these patients. Methods: Seventy-five NSCLC patients with EGFR gene positive mutation were included in the current study from May 2012 to Jul. 2014 in Ruikang Hospital A?liated to Guangxi University of Chinese Medicine. Plasma TGF-α was measured using enzyme-linked immunosorbent assay (ELISA) in all of the patients before EGFR-TKI treatment. The radiographic evaluation was performed 2 months after the therapy. The association between TGF-α and clinical outcome and its prediction e?ciency were determined, followed by the further analysis of the association between TGF-α and overall survival (OS) as well as progression-free survival (PFS). Results: After EGFR-TKI treatment, there were 20 patients with partial response (PR), 25 with stable disease (SD) and 30 with progression disease (PD) in all 75 NSCLC patients harboring EGFR positive mutation. The disease control (DC) rate reached 60%. Patients in PD group presented statistically significant higher plasma TGF-αthan patients in the DC group (P<0.01). Multivariate COX model indicated that smoking status, lymph node metastasis and plasma TGF-α levels were independent risk factors for prognosis in these patients. The ROC analysis revealed that baseline plasma TGF-α showed good prediction e?ciency [area under the curve (AUC)=0.926] and the cut-off point of TGF-α was 16.75 pg/mL. Higher level of TGF-α (≥16.75 pg/mL) was associated with smoking history, clinical stage, lymph node metastasis and clinical outcome of the patients (P<0.05). In comparison to patients with low TGF-α, the patients with high TGF-α concentration presented significantly reduced median OS and PFS (log-rank P<0.05). Conclusion: Higher plasma TGF-α (≥16.75 pg/mL) had a predictive role in EGFR-TKI resistance and poor prognosis.
ABSTRACT
Objective To explore the relationship between hormone therapy (HT) in women withovarian malignancy and prognosis. Methods HT was used in 31 patients with ovarian cancer after surgery,and 44 eases with ovarian eaneer served as controL The expression of estrogen receptor (ER)α, ERβ andprogesterone receptor (PR) was detected by immunohistoehemieal staining respectively. The level of serumealeitonin and transforming growth factor α (TGFα) was detected by radio-immune and enzyme-linkedimmunosorbent assay pre- or post-surgery, as well as half a year to one year later post-surgery respectively inthese eases. The survival curve of Kaplan-Meier and log-rank test as well as scale risk of Cox model wereused to analyze the relationship between HT and prognosis of ovarian cancer. Results ( 1 ) The results oflog-rank test showed that there was no difference in survival curve of patients with or without HT [ (1108±52), (1086±43) d; P=0.940] ; the results of scale risk of Cox model also showed that HT was not anindependent prognosis factor for patients with HT. (2) There was no relationship with HT and theaccumulated survival in patients with either positive or negative expression of ERa, ERβ and PR in tissue;as well as between HT and the level of serum TGFα pre-, post-surgery, or half a year to one year aftersurgery. (3) The level of serum caleitonin in patients without HT post-surgery half a year to one year laterwas higher than that pre-surgery [ (141±13), (95±11) μg/; P<0.05], but there was no significantdifference between patients with HT half a year to one year later past-surgery and pre-surgery [ (90±18)μg/L, (93±14) μ/L; P>0.05]. (4) There was a significant difference in body and emotion function between HT and without HT groups [(1.84±1.50), (1.45±0.82); (12.69±10.20), (12.90±11.61); P<0.05], as well as in sex quality and autonomic nerve maladjustment and in the special listmade [(1.05±0.74), (1.77±1.08); (10.10±3.21), (13.09±4.30); P<0.05]. ConclusionsThere is no adverse influence on prognosis in using of HT for patients with ovarian cancer after surgery. HTfor patients with ovarian cancer post-surgery can help keep a stable level of scmm calcitonin as well asimprove the quality of life.
ABSTRACT
Objective To study the significance of trans-sphenoid approach microsurgery in the management of pituitary adenomas. Methods Clinical data of 22 cases of pituitary adenomas treated by trans-sphenoid approach microsurgery in this hospital from January 1990 to December 2001 were analyzed retrospectively. Results The total resection rate was 68.2% (15/22). Follow- up in 17 cases for 1～13 years showed that different degree of improvement was achieved in the 12 cases of impairment in vision or visual field,but no recovery was obtained in the 5 cases of blindness. Conclusions Trans-sphenoid approach microsurgery is a minimally invasive, safe and effective method for the treatment of pituitary adenomas.