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Objective To investigate the value of serum lactate dehydrogenase (LDH) in advanced non-small cell lung cancer (NSCLC) treated with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI).Methods Pretreatment LDH level,pathological characteristic,tumor staging and treatment situation of 190 advanced NSCLC patients with EGFR sensitive mutation confirmed by pathology were retrospectively collected in Zhuhai People's Hospital of Guangdong Provice from July 2011 to July 2015.All the patients were divided into LDH normal group (LDH ≤252 U/L,n =78) and elevated group (LDH ＞ 252 U/L,n =112) according to pretreatment LDH level.Inaging evaluations of the patients were performed regularly,and the progression-free survival (PFS) and overall survival (OS) were recorded.The survival curves were plotted by Kaplan-Meier method and survival difference between patients with different LDH level was compared by logrank test.Cox regression analysis was used to analyze prognostic factors for mortality.Results The objective response rate of the LDH normal group was 76.9％ (60/78),and the elevated group was 71.4％ (80/112),with no statistically significant difference (x2 =0.716,P =0.398).The disease control rate of the LDH normal group was 89.7％ (70/78),and the elevated group was 85.7％ (96/112),with no statistically significant difference (x2 =0.676,P =0.411).The median PFS of the LDH normal group was 11.5 months,and the elevated group was 9.7 months (x2 =5.92,P =0.015).The median OS was 31.0 months in the LDH normal group,and 26.1 months in the elevated LDH group (x2 =4.79,P =0.029).Both PFS and OS of patients with elevated LDH were shorter than those of patients with normal LDH.Cox multivariate regression analysis showed that tumor staging (HR =1.652,95％ CI:1.386-2.259,P =0.018),PS score (HR =2.248,95％ CI:1.507-3.846,P ＜ 0.001),carcino-embryonic antigen (CEA) level (HR =1.250,95％ CI:1.066-1.703,P =0.037) and LDH level (HR =1.771,95 ％ CI:1.324-1.947,P =0.015) were independent prognostic factors in patients with advanced NSCLC.Conclusion Pretreatment serum LDH can not affect the objective response rate and disease control rate of EGFR-TKI in the treatment of advanced NSCLC,but can affect the PFS and OS of patients.Pretreatment serum LDH is an independent prognostic factor.
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Objective To investigate the correlation between human papilloma virus(HPV) 16/18 infection and the expression of Rb and p16 protein in bladder cancer tissue,and to analyze the relationship between HPV infection and the incidence of bladder cancer.Methods The expression of HPV16/18 E6 and E7 gene encoded protein,RB and p16 were detected by immunohistochemical method in 40 cases of bladder cancer and 40 cases of normal bladder tissues,and the correlation between them and pathological grading,stage of international union of cancer(UICC),whether recurrence or not after receiving surgery was analyzed.Results In bladder cancer tissues,HPV16/18 E6 and E7 gene encoded protein,RB and p16 positive rates were 65%,47.5%,42.5%,compared with the positive rate of normal bladder tissue samples(22.5%,92.5%,87.5%),the differences were statistically significant(P0.05).The expression of HPV16/18 E6 and E7 gene encoded protein and Rb,p16 protein were not significantly correlated(P>0.05),The expression of Rb and p16 protein were negatively correlated(P<0.05).Conclusion HPV 16/18 infection is related to the occurrence and development of bladder cancer,but its mechanism might not be related to the abnormal expression of Rb and p16 protein.
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Objective To study the FMS-like tyrosine kinase-3 (FLT3) gene, NPM1 gene and c-kit gene mutations in acute myeloid leukemia (AML) by extracting DNA from the storage of bone marrow slides, and to investigate the relationship between the three gene mutations and clinical features in AML. Methods The bone marrow slides of 55 patients diagnosed with AML were enrolled in this study. The PCR, DNA sequencing and molecular cloning were used to detect and analyse the FLT3-ITD, NPM1 and c-kit gene mutations. Patients' remission, progression and survival time were also recorded. Results The DNA was successfully extracted from the bone marrow slides with -20 ℃ frozen storage without Wright stained, chemically fixed, and room temperature storage Wright stained discoloured by phenol ∶ chloroform ∶ isoamyl alcohol method, which can be used in PCR, direct sequencing and molecular cloning sequencing analysis. 10 of the 55 cases (18.2 %) were FLT3-ITD positive, including 9 cases with heterozygous mutations and 1 case with homozygous mutation. FLT3-ITD positive group had lower complete remission (CR) rate, shorter event-free survival (EFS) time and overall survival (OS) time than the negative group (P< 0.05). 9 of the 55 cases (16.4 %) had NPM1 heterozygous gene mutations, all belonging to type A. The EFS rate of the patients with NPM1 mutation was higher in 10 months and the OS rate was higher in 19 months (P< 0.05). 3 of 9 NPM1 mutations patients were FLT3-ITD positive. The CR rates of the four groups after initial remission induction therapy in order were NPM1+FLT3-ITD-, NPM1-FLT3-ITD-, NPM1-FLT3-ITD+, NPM1+FLT3-ITD+(P<0.05). Besides, NPM1-FLT3-ITD+was a risk factor affecting the OS (RR=1.250, P=0.005). 2 of the 55 cases (3.6 %) had c-kit gene mutations, namely mutant D816H and mutant D816V. The c-kit gene mutations were not found in patients with FLT3-ITD and NPM1 mutations. Conclusions The FLT3-ITD mutation is a poor prognosis molecular marker in AML, and NPM1 mutation is a good factor for the prognosis. NPM1-FLT3-ITD+is a risk factor affecting OS. The rate of c-kit gene mutation is low in AML, without the overlap of FLT3 and NPM1 mutations.
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Objective To study the status and risk factors for falling down in elderly people in rural areas, and to provide evidences for preventions. Methods A total of 1 003 farmers aged 60 years old and over were surveyed to study the falls occurred during the previous 12 months before March 2001 in the elderly in a town of Laizhou City by cluster sampling method. Results The average incidence of falling down was 22.6%, 15.9% for men and 28.4% for women, respectively. The risk factors of falls included gender, age, single-living, falling history in the previous year, at least combined two kinds of chronic diseases, manifesting at least two symptoms, gait abnormalities, as well as complaining poor physical status and poorer general conditions than the previous year. Less social actions was negatively associated with the falls. Conclusions The falling in the elderly walkers results from an outcome of combination of multifactors. Since the complex pathogenesis, it should be prevented by a combination of several methods.