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PubMed1994

Prognostic value of the histochemical expression of helix pomatia agglutinin in advanced colorectal cancer. A univariate and multivariate analysis.

PURPOSE: The expression of helix pomatia agglutinin in advanced colorectal cancer was evaluated in order to determine whether helix pomatia agglutinin could serve as an effective prognostic indicator. METHODS: Using the histochemical procedure, the expression of helix pomatia agglutinin was studied in 117 patients with primary colorectal cancer. Sixty of 117 patients who died of either recurrence or metastasis within two years (Group 1) after resection were compared with the other 57 patients who survived for five years or longer (Group 2). RESULTS: The helix pomatia agglutinin-positive expression was seen in 34 cases of Group 1 and in only 15 cases of Group 2 (P < 0.01). Lymph node metastasis, lymphatic invasion, venous invasion, mucin production, and helix pomatia agglutinin expression all had a significant correlation with the prognosis in the univariate analysis; however, only lymph node metastasis, venous invasion, and helix pomatia agglutinin expression were prognostic factors with a significant difference in the multivariate analysis. CONCLUSIONS: Histochemical expression of helix pomatia agglutinin will indeed aid in accurately predicting the prognosis of patients with advanced colorectal cancer.

Aged↗
PubMed1996

Significant influence of accompanying chronic hepatitis status on recurrence of hepatocellular carcinoma after hepatectomy. Result of multivariate analysis.

OBJECTIVE: The aim of this study was to evaluate the correlation between the histologic status of accompanying chronic hepatitis and the recurrence rate of hepatocellular carcinoma (HCC) after hepatectomy by multivariate analysis. SUMMARY BACKGROUND DATA: Recent studies have suggested that a considerable number of intrahepatic recurrence of HCC after hepatectomy might be the results of metachronous multicentric hepatocarcinogenesis. The authors hypothesized that the incidence of recurrence due to metachronous multicentric hepatocarcinogenesis would depend on the histologic status of accompanying chronic viral liver disease, which is a main promoter of HCC. METHODS: One hundred ten patients with HCC who underwent curative resection were studied. Histologic status of accompanying chronic hepatitis was classified into the three categories: 1) normal liver or chronic persistent hepatitis (CPH, n = 13), 2) chronic aggressive hepatitis (CAH, n = 50), and 3) liver cirrhosis (LC, n = 47). RESULTS: The Cox multivariate proportional hazard model showed that the accompanying chronic viral hepatitis status (p = 0.0133), extent of hepatectomy (p = 0.0078), and number of tumors (p = 0.0475) were significantly predictive variables for recurrence-free survival. By the log-rank test, recurrence-free survival rate in patients with CPH was significantly higher than those in patients with CAH (p = 0.0005) and LC (p = 0.0075). Patients with CAH had the lowest recurrence-free survival rate (vs. LC, p = 0.028). CONCLUSIONS: The results of this study indicated the significant influence of histologic activity of hepatitis on recurrence of HCC. This might support the concept of significant contribution of multicentric hepatocarcinogenesis to recurrence of HCC after hepatectomy.

Adult↗
PubMed2002

Prognostic factors in prenatally-detected posterior urethral valves: a multivariate analysis.

To identify prognostic factors associated with chronic renal insufficiency in children with posterior urethral valves (PUV), 22 children with PUV were submitted to a systematic protocol and prospectively followed. Prognostic factors associated with fetal echography and clinical and laboratory findings were studied on admission. Median follow-up was 76 months. The analysis was conducted in two steps: in univariate analysis, variables associated with adverse outcome were identified by the Kaplan-Meier method. The variables that were significantly associated with adverse outcome were then included in a multivariate analysis using the Cox model. Eleven patients (50%) developed chronic renal failure (CRF) during follow-up. After adjustment by the multivariate model, four factors were identified as independent predictors of adverse outcome: oligohydramnios (relative risk [RR] = 10.6, 95% CI = 2.7 - 77, P = 0.02), ventilatory support (RR = 6, 95% CI = 2 - 24, P = 0.01), urea higher than 40 mg/dl (RR = 3.7, 95% CI = 0.92 - 15.0, P = 0.06), and bilateral vesicoureteral reflux (VUR) (RR = 6.1, 95% CI = 1.25 - 30, P = 0.02). On the other hand, the presence of unilateral VUR was a protective factor against the development of CRF or death during follow-up (RR = 0.92, 95% CI = 0.87 - 0.98, P = 0.05).

Child↗
PubMed1992

Multivariate analysis of morbidity and mortality from the initial surgical management of obstructing carcinoma of the colon.

Eighty consecutive patients presenting with complete large intestinal obstruction from primary carcinoma were evaluated. A multivariate analysis was performed to evaluate perioperative morbidity and mortality. There were five deaths in the immediate postoperative period (30 days). Extensive and lesser complications occurred in eight and 11 patients, respectively. There were 25 lesions of the right colon, whereas in 55 patients, the lesion was located distal to the left branch of the middle colic artery. Females were more likely to present with obstructed carcinomas of the left colon than males. Patients with an obstruction of the left colon more frequently presented with dehydration than those with a tumor of the right colon (p less than 0.05). Most carcinomas of the right colon were resected, whereas lesions of the left colon were managed with diverting colostomy in 33 patients and by primary resection in 22. Thirteen patients with carcinomas of the left colon had an immediate anastomosis without mortality. Preoperative severe cardiopulmonary disease, Acute Physiology and Chronic Health Evaluation score and advanced carcinoma (Dukes' C or D) were statistically related to early hospital morbidity and mortality, while individual physiologic parameters, site of lesion or operation performed were not. Primary resection may be performed safely in selected patients. Multivariate assessment and clinical staging may allow for appropriate patient selection and improve immediate outcome.

Aged↗
PubMed1996

A risk score for predicting outcome in patients with gastric cancer, based on stage, sialyl-Tn immunoreactivity and ploidy--a multivariate analysis.

Twelve variables were studied for possible prognostic value in 242 patients with adenocarcinoma of the stomach. Eight of these had a statistically significant effect on survival in univariate analyses. A multivariate analysis of 196 patients showed that the most significant differences in survival could be explained by 3 independent variables acting simultaneously, namely stage of disease, Sialyl Tn antigen (STn) expression and aneuploidy of the tumour cells. By adding scores for stage (1-4 points), STn expression (0-1 points) and ploidy (0-1 points) a risk score based on these 3 variables defined the patients into 6 different risk groups with statistically highly significant differences in survival (chi 2 = 107.74, DF = 1, p < 0.0001). Application of the risk score improves the prediction of outcome, may help in choosing patients for different treatment modalities, and allows more accurate stratification in clinical trials.

Aged↗
PubMed1994

Factors affecting the thiobarbituric acid test as index of red blood cell susceptibility to lipid peroxidation: a multivariate analysis.

The relationship between formation of thiobarbituric acid reactive substances (TBARS) in red blood cells (RBC) after exposure to H2O2 and factors potentially able to modulate it was investigated by a multivariate analysis in 92 healthy volunteers. The independent covariates considered were: RBC membrane fatty acids and cholesterol, RBC antioxidant enzymes and zinc, plasma vitamins A and E and serum selenium, zinc and copper. The stepwise multiple-linear-regression analysis revealed RBC membrane fatty acids and cholesterol as predictors of a consistent proportion of the RBC-TBARS variability whereas none of the antioxidants entered the equation. The unsaturation index was the most important individual predictor; RBC-TBARS increased with increasing concentrations of total omega-3 polyunsaturated fatty acids, C 20:5 omega-3 and cholesterol, whereas they decreased with increasing concentrations of total monounsaturated fatty acids, saturated fatty acids, C 16:0 and C 18:0. It is suggested that formation of TBARS, at least in currently used conditions, reflects mainly the lipid composition of the tissue under investigation, without giving sufficient information about the status of the antioxidant defences.

Adult↗
PubMed1994

Compartmental multivariate analysis of exercise ECGs for accurate detection of myocardial ischaemia.

An accurate computer-assisted diagnostic method for detection of myocardial ischaemia, called MUSTA, is developed. MUSTA is based on compartmental multivariate analysis of variables available in the exercise ECGs, and is definitively implemented in Prolog. It is heuristically developed by determining diagnostic criteria, which interrelate a modified ST/HR-slope, ST-segment value and shape, and maximum heart rate, so that concordance with the TI-201 SPECT is maximised. In the learning group consisting of 47 patients, MUSTA provides a diagnostic accuracy of 98%, the detection of ischaemia being in absolute concordance with TI-201 SPECT. MUSTA is evaluated in a similar but independent group of 60 patients. Then, accuracy is 90%, and sensitivity is 94%. The performance characteristics are significantly better than those of the standard exercise ECG, whose diagnostic accuracy in these groups is 77% and 70%, respectively. This study suggests that MUSTA is a significant improvement for computerised assessment of myocardial ischaemia.

Adult↗
PubMed1992

[New histomorphologic prognostic parameters in stomach cancer. A uni- and multivariate analysis of 445 patients].

In a retrospective series of 445 gastric cancer patients, the prognostic significance of classical histological parameters such as T-category, tumor size, lymphnode involvement and tumor grading was compared with the prognostic value of vascular invasion and the degree of tumor cell dissociation (TCD) at the invasion front. As shown in a Cox regression analysis, T-category had the highest prognostic value. Nevertheless, vascular invasion and TCD proved to be independent new parameters in a multivariate analysis, exceeding the prognostic information obtained by the combination of T-category and lymph-node involvement. In contrast, tumor grading provided no significant information. The determination of TCD at the invasion front as well as a careful search for vascular invasion may therefore provide additional useful information for identifying those patients who are at high risk and who may be candidates for adjuvant therapy in future clinical trials.

Adult↗
PubMed1998

[Multivariate analysis of clinicopathological and immunohistochemical factors in colorectal carcinomas].

OBJECTIVE: To determine the effect of clinicopathological and immunohistochemical factor on the prognosis of colorectal carcinoma. METHODS: The Cox model was used in a series of 68 colorectal carcinomas to study ten prognostic factors. These factors included tumor growth, stromal lymphocyte infiltration and fibrous tissue proliferation, degree of differentiation, Dukes stage, p53 protein, c-erbB-2 protein, P21 protein, PCNA proliferation index and EGFR. RESULTS: Monovariate analysis showed that tumor growth, stromal lymphocyte response, Dukes stage, p53, c-erbB-2 protein and PCNA index influenced prognosis significantly; multivariate analysis revealed 4 significant prognostic factors; P21, c-erbB-2 protein, Dukes stage and PCNA index. The relative risk (RR) for mortality was high in patients having P21 and c-erbB-2 co-expression. The RR of P21 and c-erbB-2 protein positive patients in Dukes A stage was higher than that of P21 and c-erbB-2 protein negative patients in Dukes B stage. CONCLUSIONS: P21, c-erbB-2 protein, PCNA index and Dukes stage were independent predictors of survival. The prognosis of patients with P21 and c-erbB-2 protein co-expression was worse than in patients without this co-expression.

Colorectal Neoplasms↗
PubMed1978

Continued use of contraception among Philippine family planning acceptors: a multivariate analysis.

The factors that contribute to continued use of contraception are examined through a multivariate analysis of data gathered in the course of the Philippine 1974 National Acceptor Survey. Twenty-five independent variables were utilized in the analysis, of which only three were found to have an appreciable effect upon continuation: the method accepted, age, and husband's attitude regarding family planning. When the sample was divided into method subgroups, several features of the service process explained variance in pill continuation, and fecundability explained variance in rhythm continuation. The findings suggest that there is considerable potential for improving the effectiveness of the Philippine program through administrative action. Better IUD services and information, more emphasis on the needs of husbands, and improvements in the ongoing support of pill users could substantially improve the amount of contraceptive protection offered by the program.

Adolescent↗
PubMed1990

Adenocarcinoma of the rectum treated by abdominoperineal excision: multivariate analysis of prognostic factors.

The aims of this study were to describe the results of 100 consecutive abdominoperineal excisions, and to try to define homogeneous subgroups of survivors using the Cox regression analysis model. There was one postoperative death. No patient was lost to follow-up. Overall 5-year survival rate was 45%. Multivariate analysis selected 3 prognostic factors: lymph node involvement (p less than 0.001), local tumour extent (P = 0.08), and extension to adjacent organs (p = 0.03). Four subgroups of patients were defined. Best survival was observed in patients (n = 43) with tumour invading into the subserosa (W1) or less and without lymph node metastasis (N0), with a 5-year survival of 82% (group 1). Patients in Group 2 (n = 18) had a tumour invading into the muscularis propria or less with lymph node metastasis (W0 N+), or into the serosa or perirectal fat without lymph node invasion (W2 N0), with a 5-year survival of 51%. Patients in Group 3 (n = 17) had a tumour invading into the subserosa with lymph node invasion (W1 N+) or extension to adjacent organ without lymph node invasion (W3 N0) with a 5-year survival of 24%. Patients in group 4 (n = 22) had extension into the serosa or perirectal fat or more with lymph node invasion (W2 N+) with a 5-year survival of 2%. This scoring system is simple, practical and easy to apply. If it can be confirmed by other studies, its routine adoption could be justified.

Adenocarcinoma↗
PubMed1993

When can cerebral palsy be prevented? The generation of causal hypotheses by multivariate analysis of a case-control study.

Causal hypotheses for spastic cerebral palsy were sought by comparing a population based sample of 183 cases with 549 matched controls. A time-ordered multivariate analysis was used to distinguish confounders and consequences of disease from possible causes, which could be single factors or sequences of factors. Eighteen factors were identified as having an association with spasticity that did not arise by confounding with other identified factors nor as a consequence of the disease. Nearly half the cases (48.6%) but only 14.4% of controls experienced one or more of these factors, but no one factor was experienced by > 11%, and most by < 5%, of cases. Those factors identified as occurring before labour commenced affected 35% of all cases. The proportion of cases experiencing identified factors and the distribution of those factors between epochs varied with gestation of delivery and with description and severity of impairment. The possible timing of causes in cases without identified factors and the role of preterm birth and poor intrauterine growth are discussed. We conclude that there were many pathways to spastic cerebral palsy many of which could not be identified. Each contributed only a small proportion and many may have been multifactorial. Intrapartum initiation of the aetiological pathway was relatively unimportant, being likely in about 9% of cases, but the majority of pathways commenced predelivery.

Adult↗
PubMed1995

A multivariate analysis of prognostic factors in thymoma.

BACKGROUND: Considering the prognostic factors of thymoma, the clinical stage is the most important, while controversies exist about other clinicopathologic factors. A multifactorial study was carried out to clarify the relationship between prognosis and sex, age, tumor size, presence of myasthenia gravis, staging, epithelial subtyping, lymphocyte/epithelial cell ratio (L/E ratio) and other adjuvant pathological features. METHODS: One hundred and thirty-seven cases were collected in Veterans General Hospital-Taipei from 1961 to 1993. The aforementioned features were studied. Kaplan-Meier's actuarial survival analysis was adopted, with Logrank test, to determine the significance of overall heterogeneity and trend. Cox proportional hazard model was also used for multivariate analysis. RESULTS: Among all tested prognostic factors, staging had the highest significance (relative risk = 3.00, p < 0.001) and age had only a moderate one (relative risk = 1.04, p = 0.011). No other clinicopathological factor showed any statistical significance for prognosis. CONCLUSIONS: Staging remains of greatest usefulness in predicting the biological behavior of thymoma. The effect of age requires more investigation. Other clinicopathological features have no definite influence in survival expectancy.

Adolescent↗
PubMed1991

Influence of di- and tri-phenylethylene estrogen/antiestrogen structure on the mechanisms of protein kinase C inhibition and activation as revealed by a multivariate analysis.

We have performed a systematic study of the interaction of 36 di- and tri-phenylethylene derivatives (DPEs and TPEs) with protein kinase C (PKC). The results were submitted to a multivariate analysis in order to identify the structural features that might be implicated in interference with the activity of three PKC subspecies under three enzyme activation conditions. Four groups of test-compounds, each with common chemical features, could be distinguished clearly. The first group comprised all TPEs substituted with at least one basic dialkylaminoethoxy side-chain. These inhibited type alpha, beta and gamma PKC subspecies activated by Ca2+ and phosphatidylserine (PS) with or without diolein (DO) at micromolar concentrations but did not inhibit protamine sulfate phosphorylation. The other effectors, which all possessed a 1,1-bis-(p-hydroxyphenyl) ethylene moiety, influenced PKC activity at high concentrations (30-200 microM) and could be divided into two groups. One group constituted PKC inhibitors in the TPE series and inhibited PKC activated by Ca2+, PS and DO, as well as protamine sulfate phosphorylation. The other group constituted dual-type inhibitors/activators in the DPE series and stimulated PKC in the presence of Ca2+ and low PS concentrations but inhibited the enzyme in the simultaneous presence of DO. The fourth group of compounds was inactive and had, for the most part, one or two substituents with weak steric hindrance. In agreement with previous data for six lead compounds, this study suggests that, in these chemical series, a basic amino side-chain leads to interaction with phospholipid and the regulatory domain of PKC, whereas a 1,1-bis-(p-hydroxyphenyl) ethylene moiety leads to interaction with the catalytic domain of the enzyme.

Animals↗
PubMed2006

Ten years of experience with weekly chemotherapy in metastatic breast cancer patients: multivariate analysis of prognostic factors.

Weekly chemotherapy administration represents an emerging option for the treatment of metastatic breast cancer. In order to identify clinical and biological prognostic factors for outcome, we performed a multivariate analysis in a 10-year experience of weekly chemotherapy for metastatic breast cancer patients. The original databases of phase II trials of metastatic breast cancer patients who had undergone first-line weekly chemotherapy were collected. Clinical and biological covariables were screened for a possible relationship with time to progression and overall survival in a Cox model. From 1990 to 2003, 184 patients were enrolled in three consecutive phase II studies, to evaluate activity and tolerability of weekly epirubicin with lonidamine or vinorelbine or paclitaxel. All patients were evaluable for clinical variables; histological samples were available in 40 patients. At a median follow-up of 24 months, median time to progression was 9 months (95% confidence interval 8-10) and median overall survival was 34 months (95% confidence interval 24-42). Independent variables were response (hazard ratio 2.34, P<0.0001), receptor status (hazard ratio 1.62, P=0.01) and performance status (hazard ratio 2.31, P<0.0001) for time to progression, and response (hazard ratio 1.86, P=0.005), performance status (hazard ratio 2.81, P<0.0001), dominant metastatic site (hazard ratio 2.27, P<0.0001) and enrollment period (hazard ratio 2.51, P=0.001) for overall survival. Although no biological factors were entered into the Cox model owing to the small sample size, some subpopulations showed a negative trend in survival. In our series of patients who had undergone weekly chemotherapy for metastatic breast cancer, independent prognostic factors for survival improvement were responders, performance status 0-1, nonvisceral dominant metastatic site and enrollment period. A greater sample population is needed to extensively screen for biological prognostic factors.

Adolescent↗
PubMed1998

Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of prognostic factors.

This study is the first report in which the relationship between the progression of renal involvement in Henoch-Schönlein purpura (HSP) and various factors was evaluated using a multivariate analysis. Sixty-five (33.5%) of 194 patients with HSP developed renal involvement from three days to 17 months after the onset of the disease. The plasma coagulation factor XIII (F XIII) activity of 97 patients was examined, and 51 (54.3%) of them showed a decreased activity. A univariate analysis showed that an age at the onset of more than seven years, persistent purpura and a decreased F XIII activity all increased the risk of developing renal involvement. A Cox regression model analysis indicated severe abdominal symptoms, persistent purpura and decreased F XIII activity to be significant risk factors and their hazard ratios were 3.26, 11.53 and 2.27, respectively. Corticosteroid treatment had a hazard ratio of 0.36 and was considered to decrease the risk of developing renal involvement. Based on these findings, patients who have the risk factors for renal involvement should be treated with corticosteroids at the onset of the disease to prevent developing renal involvement.

Adolescent↗
PubMed1987

Multivariate analysis of Hachinski's Scale for discriminating senile dementia of the Alzheimer's Type from multiinfarct dementia.

The need for an accurate clinical scale to aid in the diagnosis of senile dementia of the Alzheimer's type (SDAT) is clear in terms of both patient care and research. The ischemic scale of Hachinski, which differentiates multiinfarct dementia from primary degenerative dementia, has been criticized as lacking in validity. This study is a cluster by case analysis of the data from Hachinski's original report. The multivariate analysis provides support for those clinicopathologic studies that have found Hachinski's ischemic score of value.

Alzheimer Disease↗