[Prognostic markers of advanced non-small cell lung carcinoma -  assessing the significance of oncomarkers using data-mining techiques RPA]. / Prognostické markery pokrocilého nemalobunkového karcinómu plúc -  hodnotenie významu onkomarkerov pomocou data-miningovej metódy RPA.

INTRODUCTION: Identification of new prognostic factors can help in designing future clinical studies. In the case of advanced non-small cell lung cancer, there might be good candidates - tumor markers CYFRA 21-1, CEA or NSE [1-8]. It is possible to evaluate the relationship between their expression and prognosis by data mining technique recursive partitioning and amalgamation. PATIENTS AND METHODS: We analyzed retrospective data of 162 patients of Oncology clinics in Trnava. All of these patients were admitted between 2008 and 2012 for the administration of first-line chemotherapy according to current recommendations. We evaluated the impact of known pretreatment prognostic markers - performance status, weight loss, smoking, age, sex, stage, histologic subtype, comorbidity and oncomarkers CYFRA 21-1, CEA or NSE, as well as combinations of these factors on survival. RESULTS: Our analyses showed that there are three subgroups of patients with good, intermediate and unfavorable prognosis. Oncomarkers played an important role in formation of a subgroup of 49 patients with good prognosis - including patients with no pretreatment weight loss and low levels of CEA ( 4.1 ng/ml) or NSE ( 11.1 ng/ml). In this subgroup, the median survival time was at least 16 months (not achieved) and the difference in survival compared to the rest of the group was highly statistically significant (risk ratio 5.21, 95% CI 1.41-19.28; p < 0.0001). CONCLUSION: We showed the prognostic significance of low levels of NSE and CEA oncomarkers in the group of patients with no pretreatment weight loss. Recursive partitioning and amalgamation is a useful data mining method, but the generated hypothesis needs to be confirmed by further clinical study designed for this purpose

High prevalence of prediabetes and diabetes in a population exposed to high levels of an organochlorine cocktail.

AIMS/HYPOTHESIS: A heavily polluted area of Eastern Slovakia was targeted by the PCBRISK cross-sectional survey to search for possible links between environmental pollution and both prediabetes and diabetes. METHODS: Associations of serum levels of five persistent organic pollutants (POPs), namely polychlorinated biphenyls (PCBs), 2,2'-bis(4-chlorophenyl)-1,1-dichloroethylene (p,p'-DDE), 2,2'-bis(4-chlorophenyl)-1,1,1-trichloro-ethane (p,p'-DDT), hexachlorobenzene (HCB) and beta-hexachlorocyclohexane (beta-HCH), with prediabetes and diabetes were investigated in 2,047 adults. Diabetes and prediabetes were diagnosed by fasting plasma glucose in all participants and by OGTT in 1,220 compliant participants. RESULTS: Our population was stratified in terms of individual POPs quintiles and associations between environmental pollution, prediabetes and diabetes were investigated. Prevalence of prediabetes and diabetes increased in a dose-dependent manner, with individuals in upper quintiles of individual POPs showing striking increases in prevalence of prediabetes as shown by OR and 95% CI for PCBs (2.74; 1.92-3.90), DDE (1.86; 1.17-2.95), DDT (2.48; 1.77-3.48), HCB (1.86; 1.7-2.95) and beta-HCH (1.97; 1.28-3.04). Interestingly, unlike PCBs, DDT and DDE, increased levels of HCB and beta-HCH seemed not to be associated with increased prevalence of diabetes. Nevertheless, individuals in the 5th quintile of the variable expressing the cumulative effect of all five POPs (sum of orders) had a more than tripled prevalence of prediabetes and more than six times higher prevalence of diabetes when compared with the 1st referent quintile. CONCLUSIONS/INTERPRETATION: Increasing serum concentrations of individual POPs considerably increased prevalence of prediabetes and diabetes in a dose-dependent manner. Interaction of industrial and agricultural pollutants in increasing prevalence of prediabetes or diabetes is likely.

Critical appraisal of prognostic factors for transobturator tape implantation.

OBJECTIVES: The aim of the study was (1) to compare early results of transobturator tape (TOT) implantation in women with lower and higher Valsalva leak point pressure (VLPP) and (2) to find out significant and independent prognostic factors of TOT implantation. MATERIAL AND METHODS: 97 female patients (pts) underwent TOT implantation between March 2004 and September 2007. We observed preoperative parameters including VLPP, urine leakage (PWT1), quality of life (IQOL1), age, BMI, parity, previous anti-incontinence surgery, hysterectomy status (HYE) and symptoms of OAB. According to VLPP value, pts were divided into two groups, namely those with lower VLPP values (< or =60 cmH2O) and those with higher VLPP values (> 60 cmH2O). Two different tapes were used for TOT implantation (resorbable and non-resorbable). Six months after surgery, urine leakage (PWT2) was reassessed and pts were classed into two main categories as 'cured' (PWT2 < or =2 g), or 'not cured' (PWT2 >2 g). RESULTS: Pts with lower VLPP values had significantly lower cure rates than those with higher VLPP values (43.8% vs. 81.5%, p < 0.001, respectively). Univariate logistic regresion analysis identified VLPP, PWT1, IQOL1, age, HYE, and TOT type parameters as significant factors for cure. Of these significant parameters, the multivariate logistic regresion analysis identified PWT1 and TOT type as the only independent ones. CONCLUSIONS: Pts with lower VLPP values are at a five-fold greater risk of not being cured than those with higher VLPP values. Preoperative urine leakage and TOT type are the only independent prognostic factors for cure after TOT implantation (Tab. 5, Fig. 3, Ref. 32).