SEARCH · PubMed Health

Results for “Prognostics”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources

PubMed1987

[Prognostic factors in operated non-small cell cancer of the lung. Study from a randomized therapeutic trial].

This article presents the results of a prognostic study of primary resected lung cancer (non-small cell). The data result from a randomised clinical trial of immunotherapy with a non-specific adjuvant; the follow-up was between four to seven years. Thirty-five clinical, biological and anatomo-pathological parameters were gathered at the time of inclusion in the trial. The response criteria used were survival without recurrence and total survival. A multivariate analysis using the Cox's model was carried out for each criterion. At the reference date of the 1st April 1985, 125 relapses and 132 deaths were counted amongst 219 patients; there was only one patient lost to follow-up and only 39 missing data were observed. The negative therapeutic results of the immunotherapy used were confirmed by this new intermediate analysis. The rate of survival without recurrence at 5 years was 43% and the overall survival at five years was 42%. The use of Cox's model to show the prognostic information at the 5% level for survival without recurrence could be summarised by five factors: main staging (the prognostic factor), leucocytosis, the cutaneous reaction to proteus, Karnofsky index and presence of physical signs. For stages I and II the outcome was identical and no factor was predictive at the 5% level. For stage III the cutaneous reaction to proteus and leucocytosis were prognostic. For overall survival, the prognostic information at the 5% level could be summarised by five factors: staging (main prognostic factor), leucocytosis, Karnofsky index, presence of physical signs and lymphocytosis. For stages I and II whose outcome was identical only Karnofsky index and lymphocytosis were predictive at the 5% level.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Non-Small-Cell Lung↗

PubMed1987

Prognostic factor analysis in acute lymphocytic leukemia of childhood.

The analysis of clinical and hematological data for prognostic relevance in 200 children with acute lymphocytic leukemia (ALL), diagnosed between January 1964 and December 1980, showed that the importance of single risk factors has changed due to improvements in therapy. Morphology and cytochemistry lost their prognostic value they had in those patients treated before October 1971. In the children treated in the seventies, the WBC became the most important prognostic factor, followed by infiltrate size and age. (Age was less important than infiltrates for remission duration, but more for survival.) Immunological markers were evaluated in 56 children, since 1974. Because of the small number, no significance as risk factor was found. Those 25% with E+ blasts tended to have only a slightly worse course than "non-T-non-B"-ALL. Treatment became a highly significant risk factor, because of the improvement in results between those patients treated with CALGB protocol 6801 and those on protocol 7111. Two steps were responsible for this: better treatment strategies, and, most important, CNS-prophylaxis (or "sanctuary"-treatment) in all patients. Even in the sixties, where IT methotrexate alone was given sporadically, omitting the CNS-prophylaxis represented an important risk factor. Since 1971, most patients received cranial irradiation or intermediate dose methotrexate as second mode of CNS-prophylaxis. This resulted in a significant decrease in the incidence of CNS relapse. CNS-prophylaxis mode therefore represented a significant prognostic factor, although age, WBC and infiltrates had become more important. Evaluation of the clinical and hematological data gave the following limits for an increased or lesser risk: WBC over 30.G/l: high risk, under 10.G/l: favourable. Age: below 1 year and over 10 years: high risk, 1-2 years: probably moderately increased risk. Infiltrates: no palpable hepatosplenomegaly and no lymph nodes: favourable, all palpable infiltrates: "standard" or increased risk. Platelets (under 30.G/l) represented a minor good risk factor. The common ALL antigen (CALLA) was not yet examined in this series, calling it a favourable factor is based on recent experience from other centers. T-markers are probably not a risk factor by themselves, but other poor prognostic signs are usually associated and of primary importance. If treatment will be based on risk classification, it is important to keep in mind that treatment improvements might change the significance of any prognostic factor completely.

Adolescent↗

PubMed1979

Short-term prognostic index in acute myocardial infarction. Multivariate analysis by Cox model.

A new multivariate stepwise linear regression analysis (Cox's model) with survival time as prognostic endpoint was utilized in 281 patients with acute myocardial infarction. From 18 prognostic factors occurring during the first 5 days in the Coronary Care Unit a new prognostic index was calculated for the chance of survival in the first 36 days after admission. The significant prognostic variables were heart failure, cardiogenic shock, atrioventricular block and age. The total group of patients was classified in 6 subgroups with different mean indices and prognosis. There were 2 large groups of patients with relative bad and good prognosis (with and without heart failure). Over half of the patients had no prognostic variables. There was a trend of overestimating the expected deaths. A definite cardiac cause of death was shown by 23 patients (82%). This prognostic index based on the 4 variables can for the individual patient predict the chance of survival, which can be the basis of an individualized duration of hospital stay.

Age Factors↗

PubMed1981

[Prognostication of neonates by compact polygraphy (author's transl)].

The polygraphic methods currently available for the prognostication of high risk neonates are timeconsuming, almost inaccessible to visual analysis and unsuited for clinical practice. A polygraphic method has been devised using a restricted number of standardized evaluation criteria arranged according to optimalisation principles with a reduction of observation time to three sleep cycles to an average of 90 minutes. Using this type of "compact polygraphy" 135 newborn infants were divided in a "simple" and a "complicated" group. Their follow-up over the first year of life showed that abnormal EEG-tracing and/or clinical manifestations of early epilepsy occurred only in infants classified as complicated. No seizures occurred in the simple group. 40% of the patients with complicated prognostication showed neurological abnormalities vs. 8% in the simple group, confirming the prognostic value of compact polygraphy. Since the risk of developing epilepsy was 20% in newborns with postnatal seizures and complicated prognostication, preventive treatment with antiepileptic drugs is recommended in these infants. On the other hand newborns with postnatal seizures and simple prognostication can be spared the longtime exposure to barbiturates or other anticonvulsants. From our data it appears that compact polygraphy is clinically feasible and has a higher predictive accuracy than any of other currently available practical prognostication methods.

Cerebral Cortex↗

PubMed1980

Prognostic knowledge: interest and methods.

The value of prognostic information and some of the statistical aspects of prognostic studies are discussed. In the first part, seven areas of medical activity where knowledge of prognostic factors is used are identified: prediction of disease evolution, treatment decisions, design and analysis of clinical trials, comparison of non-randomized series of patients, assessment of additional clinical examinations and laboratory tests, understanding of the physio-pathology of disease, screening. In the second part, the nature of the data collected in prognostic studies is discussed, and a few statistical methods useful for the identification of prognostic factors are outlined. The paper concludes with an example of a prognostic study in Chronic Lymphocytic Leukemia.

Clinical Trials as Topic↗

PubMed1995

College of American Pathologists Conference XXVI on clinical relevance of prognostic markers in solid tumors. Report of the Colorectal Cancer Working Group.

The College of American Pathologists Conference XXVI in June 1994 was devoted to a discussion of the clinical relevance of prognostic factors in three solid tumors (breast, prostate, and colorectal). The group considering prognostic factors for adenocarcinoma of the large gut consisted of 15 pathologists, investigators, and surgeons. The group concluded that only a few items are well supported in the existing literature and can be recommended for routine clinical use at this time (pathologic TNM information and stage, tumor type, tumor grade, extramural venous invasion, and preoperative serum carcinoembryonic antigen level). According to the classification system used at the conference, these markers warrant categorization as important prognostic factors (category I). A few factors should be considered as potentially useful after further study (category II). Furthermore, the group agreed that all other current measurements of so-called prognostic factors do not warrant the same recognition of importance, either because they have been studied insufficiently or studies have demonstrated that they do not contribute to prognostication. These additional items were placed in category III. It was also concluded that the statistical methods used to identify and validate prognostic markers, as well as their integration into single statements of prognosis need further national evaluation and standardization.

Biomarkers, Tumor↗

PubMed1995

Prognostic factors in erythrodermic mycosis fungoides and the Sézary syndrome.

BACKGROUND AND DESIGN: There are no large studies evaluating patients with erythrodermic mycosis fungoides and Sézary syndrome to determine the important prognostic factors that may influence survival. This is important since new treatment modalities have been proposed as superior to existing primary therapies. We performed a retrospective cohort study of 106 patients with erythrodermic mycosis fungoides and Sézary syndrome, followed up in the Stanford (Calif) Mycosis Fungoides Clinic, to define the important prognostic factors in this group. RESULTS: Patients younger than 65 years have a more favorable survival profile than those 65 years or older (P < .005). Longer duration of symptoms before diagnosis ( > or = 10 years) tends to be associated with more favorable prognosis (p = .055). Lymph node stage is significantly correlated with survival; patients with overall stage III disease have more favorable prognosis than those with stage IV disease (P < .001). Patients with circulating Sézary cells in their blood have a significantly worse prognosis than those without (P < .005). Patient sex or race had no significant effect on overall survival outcome. Three distinct prognostic groups were identified, "favorable," "intermediate," and "unfavorable," according to the number of unfavorable prognostic factors (P < .005). The median survival in each group is 10.2, 3.7, and 1.5 years, respectively. CONCLUSIONS: In patients with erythrodermic mycosis fungoides and Sézary syndrome, the important prognostic factors are patient age at presentation, the overall stage, and peripheral blood involvement. Survival varies widely, depending on these variables. These prognostic factors should be evaluated when analyzing survival and/or treatment efficacy data of these patients.

Adult↗

PubMed1995

[Histologic classification and morphologic prognostic factors in malignant ovarian tumors].

Most cases of death in genital neoplasms of females are caused by ovarian cancer. Prognostic factors are the postoperative tumor, tumor stage (FIGO, pTNM), age, tumors among family, and the reproductive history. On the basis of 710 malignant ovarian tumors we describe the histogenetic classification and compare the morphologic diagnosis with additional prognostic factors by literature to give a practical review of ovarian neoplasms. The morphologic prognostic factors are the histological subtype, tumor grading and perhaps the receptor status. Worse prognosis, despite of tumor grading, show undifferentiated carcinomas, followed by the serous and mucinous subtype. Endometrioid carcinomas have the best prognosis. Malignant Mullerian tumors show a very aggressive behavior. After the introduction of polychemotherapy the sex-cord- and germ cell-tumors show better prognoses. New prognostic factors are DNA-parameters (ploidy, S-phase-fraction), detection of oncogenes and tumor suppressor genes, cellular adhesion molecules (integrins, CD 44-splicing variants), and the proliferation rate of the tumor. Perhaps, these factors show prognostic relevance for individual treatment. A correct histologic classification with consideration of all morphology related prognostic factors and the knowledge about them is necessary for oncologists to choose the optimal individual therapeutic treatment.

Biomarkers, Tumor↗

PubMedDate not supplied

Vascular space invasion and inflammatory stromal reaction as prognostic factors in patients with surgically treated cervical cancer stage IB to IIB.

We assessed the prognostic value of the local tumor characteristics inflammatory stromal reaction (ISR) and vascular space invasion (VSI) together with established prognostic criteria, in cervical cancer patients. One hundred and forty-two patients with carcinoma of the cervix stage IB to IIB undergoing radical hysterectomy and lymphadenectomy between October 1980 and September 1990 were included in the study. Pelvic lymph node involvement, stage, parametrial involvement, age and histological tumor type were analysed together with VSI and ISR as prognostic factors. The most important prognostic parameters for recurrence-free interval and overall survival in the univariate analysis were pelvic lymph node involvement (P-value < 0.0001/0.0001) and stage (P-value < 0.0001/0.0005). ISR and VSI showed a significant prognostic value for recurrence-free interval (both P-values = 0.0014) and overall survival (ISR: P-value < 0.0001; VSI: P-value = 0.0018). In the multivariate analysis ISR showed an independent prognostic value for overall survival (P-value = 0.03, Relative Risk = 5.4, 95%-confidence interval 1.2-24.5). ISR, reflecting the biological behavior of the tumor, should be considered in the evaluation of prognosis in surgically treated squamous cell carcinoma of the cervix.

Adult↗

PubMedDate not supplied

Estimate of expected survival at diagnosis in Hodgkin's disease: a means of weighting prognostic factors and a tool for treatment choice and clinical research. A report from the International Database on Hodgkin's Disease (IDHD).

PURPOSE: The aim was to identify a mathematical model that, when fitted with the survival time distribution of a Hodgkin's disease population, would provide a reliable estimate of expected survival at diagnosis for any new Hodgkin patient. This model would be based upon a multivariable selection of the best prognostic factors evaluable at diagnosis and its forecast could be of assistance in the choice of treatment. METHODS: The study sample consisted of the 5,023 patients whose basic clinical information was collected into the IDHD. These were people treated with standard protocols over the last two decades in 18 institutions. Several survival time distributions (exponential, Weibull, Gompertz, log-logistic and log-normal) were investigated to find the one that best fit the data and to relate its parameters to patient prognostic characteristics. RESULTS: The log-normal model provided the best fit for the data. The most statistically significant prognostic covariates were stage, age, histotype, B symptoms, serum albumin, sex and involved area distribution. Mediastinal, extranodal or bone marrow involvement, erythrocyte sedimentation rate, hemoglobin, serum alkaline phosphatase and lactate dehydrogenase did not add significant information. An equation containing these seven variables was derived to estimate median survival. Five distinct prognostic classes were identified by four cut-off values for this estimate. CONCLUSIONS: Direct use of estimated median survival or allocating each patient into one of the five prognostic classes allows better tailoring of clinical strategies according to prognostic characteristics, more accurate patient stratification and evaluation of results in clinical trials and metaanalyses. Instructions are given for using this tool for both clinical and investigational purposes.

Adolescent↗

PubMed1994

Evaluation of prognostic factors and staging in gestational trophoblastic tumor.

OBJECTIVE: To evaluate factors influencing survival and compare current classification systems in women treated for malignant gestational trophoblastic tumor. METHODS: A consecutive series of 454 women treated between 1968-1992 was reviewed retrospectively to identify potential clinical prognostic factors using univariate analysis of life tables. All patients were evaluated using clinical classification, World Health Organization, and recently modified International Federation of Gynecology and Obstetrics (FIGO) staging systems, applied retrospectively. Multivariate Cox regression analysis was used to model potential independent prognostic factors within subsets of the patient population. RESULTS: Factors identified by univariate analysis as potential prognostic influences included age, duration of disease, type of antecedent pregnancy, clinicopathologic diagnosis, site of metastases, number of metastatic sites and foci, tumor size, and prior therapy. The pre-therapy hCG level was not significantly associated with survival (P < .04). Multivariate Cox modeling consistently identified prior therapy, type of antecedent pregnancy, number of metastatic sites, and duration of disease as independent prognostic factors. Clinicopathologic diagnosis and hCG level were of borderline significance only in some models of the total patient population. All classification systems were able to identify low- and high-risk subsets of patients with approximately equal efficiency. The addition of FIGO substages enhanced discrimination between prognostic groups in patients with stage III disease. CONCLUSIONS: Existing systems for the classification of malignant gestational trophoblastic tumor are based in part on factors that are not independently prognostic, such as hCG level or tumor size. These systems discriminate between low- and high-risk patients with approximately equal efficiency. The clinical classification system is currently preferred for determining initial therapy in women with malignant gestational trophoblastic tumors.

Chorionic Gonadotropin↗

PubMed1994

Prognostic impact of urokinase, urokinase receptor, and type 1 plasminogen activator inhibitor in squamous and large cell lung cancer tissue.

We have studied the prognostic value of urokinase-type plasminogen activator (uPA), uPA receptor (uPAR), and type 1 plasminogen activator inhibitor (PAI-1) in tumor extracts from 84 patients with squamous cell lung carcinoma and 38 patients with large cell lung carcinoma, measuring each molecule with sandwich enzyme-linked immunosorbent assays. High uPAR levels were significantly associated with short overall survival in patients with squamous cell lung carcinomas when the median value was used as a cutoff point (P = 0.038), while no statistically significant prognostic impact of uPA and PAI-1 levels was found in this group of patients. The combination of high uPAR and high PAI-1 levels did, however, have a particular significant association with short overall survival (P = 0.008). None of the 3 components was found to have a statistically significant prognostic impact in the group of 38 large cell lung cancer patients. There was a positive correlation between uPAR and PAI-1 levels in both groups and between uPA and uPAR levels in the large cell carcinoma patients. In a multivariate analysis, high uPAR was found to be an independent prognostic variable in squamous cell carcinoma patients, with a relative risk of 2.1 (95% confidence interval, 1.1-4.0) and tumor size the only other significant prognostic parameter. These data suggest that uPAR is an important prognostic factor in squamous cell lung carcinoma. In addition to the potential direct clinical usefulness, this information could be helpful in understanding the biology of this disease and developing new therapeutic approaches.

Aged↗

PubMed1995

[Prognostic factors in liver tumors].

The prognosis of patients with hepatocellular carcinoma is dismal. Long-term survival and cure of patients with hepatocellular carcinoma (HCC) can be expected only after resection or hepatectomy followed by transplantation. Thus, prognosis primarily depends on the possibility of resective surgery, which is determined predominantly by anatomic extent of disease. This survey deals with factors that become effective after resection or transplantation and that have prognostic significance in univariate or multivariate analyses. Several studies have shown that resection for cure (R classification) and anatomical extent of the tumors (TNM) were the most important prognostic factors. Prognostic factors other than TNM and R can be grouped into clinical findings and pathological features. As to clinical findings, performance status is an important prognostic factor in one multivariate analysis. The effects of other factors as age, sex, tumor site, and hepatomegaly on prognosis were discussed controversially. As might be expected, studies on pathological factors yielded different results. Histological grade had an influence in one study, but not in another. Histological type and coexisting cirrhosis were important in multivariate analysis only in resected patients. The majority of factors (capsule formation, dysplasia of adjacent liver tissue, mitotic activity, bile production) were only investigated in univariate analyses. There are only few studies evaluating the prognostic importance of molecular pathology factors. None of them has shown convincing evidence that these parameters may give information more important than TNM and R classification. The prognostic importance of TNM for patients not treated by resective surgery is emphasized in many studies. Ascites, toxic syndrome, and laboratory variables as bilirubin, blood urea nitrogen, and serum albumin were independent predictors of survival. The prognosis of patients with cholangiocarcinoma is even worse than that of HCC-patients and only 25% patients resected with stage-II-tumors can be expected to survive for five years.

Age Factors↗

PubMed1997

Prognostic factors for clinically localized prostate carcinoma: analysis of 938 patients irradiated in the prostate specific antigen era.

BACKGROUND: Pretreatment serum prostate specific antigen (PSA) level is a powerful prognostic factor for clinically localized prostate carcinoma. The traditional prognostic factors, T classification and Gleason score, appear to have been relegated to a minor position. This study was conducted to evaluate the relative prognostic roles of PSA, T classification, and Gleason score in a large cohort of men irradiated in the PSA era. METHODS: The authors analyzed the outcome for a group of 938 men with T1-T4, N0 or NX, M0 prostate carcinoma who received definitive external beam radiation therapy as their only initial treatment during the period 1987-1995. The T classifications were as follows: T1, 283 (30%); T2, 360 (38%); T3/T4, 295 (31%). Gleason scores were as follows: Gleason 2-6, 580 (62%); Gleason 7, 224 (24%); Gleason 8-10, 122 (13%). Pretreatment PSA levels (ng/mL) were as follows: PSA < or = 4, 167 (18%); PSA 4 to < or = 10, 363 (39%); PSA 10 to < or = 20, 259 (28%); PSA > 20, 149 (16%). At a mean follow-up of 43 months (range, 6-106 months), disease outcome specified as relapse/rising PSA, local recurrence, or metastasis was analyzed using univariate and multivariate techniques. RESULTS: The 6-year actuarial incidences of relapse/rising PSA, local recurrence, and metastases were 48%, 27%, and, 6%, respectively. In multivariate regression, pretreatment PSA level, T classification, and Gleason score were each independently highly significantly (P < 0.001) correlated with every endpoint. Pretreatment PSA level was the most significant variable for rising PSA and local recurrence, and T classification was the most significant variable for metastatic relapse. Using relapse/rising PSA as the endpoint, the authors formulated a highly significant 6-tier prognostic grouping based on PSA, T classification, and Gleason score, as follows: Category I: T1/T2, PSA < or = 4, and Gleason 2-6 (relapse rate, 6%); Category II: T1/T2, PSA < or = 4 and Gleason 7-10, or PSA 4 to < or = 10 and Gleason 2-7 (relapse rate, 30%); Category III: T1/T2, PSA 4 to < or = 10 and Gleason 8-10, or PSA 10 to < or = 20 and Gleason < 8 (relapse rate, 40%); Category IV: T3/T4, PSA < 10 (relapse rate, 46%); Category V: T3/T4, PSA 10 to < or = 20, and Gleason < 8 (relapse rate, 57%); Category unfavorable: any T, PSA > 20 and any Gleason, or PSA 10 to < or = 20 and Gleason 8-10 (relapse rate, 88%). CONCLUSIONS: The establishment of T classification and Gleason score as independent prognostic factors bridges an apparent gap between an older era and the current PSA era. PSA has supplemented, rather than supplanted, the utility of the traditionally established prognostic factors for clinically localized prostate carcinoma.

Aged↗

PubMed1997

P90 exceeding rate as a prognostic factor in primary malignant melanoma of the skin. A DNA image cytometric study.

OBJECTIVE: To study the prognostic value of DNA image cytometry in primary skin melanomas. STUDY DESIGN: DNA image cytometry was performed on 62 stage I, Clark level II-V, primary skin melanomas. The DNA histograms were classified into three categories (diploid, nondiploid and aneuploid) according to the percentages of cells with higher-than-diploid and higher-than-twice-the-diploid DNA content (the P90 and 2P90 exceeding rates [ERs]). The prognostic value of P90ER, 2P90ER, type of DNA histogram, melanoma thickness, Clark level, and patient age and sex were analyzed for disease-specific survival with Cox's stepwise proportional hazards model. RESULTS: Aneuploid DNA histograms were as common in thin as in thick melanomas. Melanoma thickness and P90ER had prognostic value in univariate analysis, but in the multivariate analysis only P90ER had independent and significant prognostic value. CONCLUSION: Aneuploidy is a common feature of malignant melanoma, and it is as common in thin as in thick melanomas. P90ER has more prognostic value than the type of DNA histogram. The prognostic value of P90ER as compared with melanoma thickness should be studied further.

Adult↗

PubMed1997

Prognostic significance of Bax protein expression in diffuse aggressive non-Hodgkin's lymphoma.

Bax is a proapoptotic member of the Bcl-2 protein family. The incidence and prognostic significance of Bax protein expression in diffuse non-Hodgkin's lymphomas with a large cell component (DLCL) was determined by an immunohistochemical method by using paraffin-embedded tumors from a cohort of patients treated uniformly with combination chemotherapy (n = 139). All patients were between 16 and 70 years of age and had advanced stage disease of diffuse large cell type (diffuse mixed, diffuse large cell, immunoblastic, or anaplastic large cell). Paraffin sections from diagnostic biopsies were successfully immunostained for Bax in 113 cases. Of these, 7 (6%) tumors were scored as Bax immunonegative (< 1% Bax-stained tumor cells), 42 (37%) as low (1% to 10%), 9 (8%) as low-intermediate (11% to 30%), 25 (22%) as high-intermediate (31% to 70%), and 30 specimens (27%) as high for Bax expression (> 70%). Of the 7 Bax-immunonegative lymphomas, all also scored low (< or = 10% immunostained tumor cells) for Bcl-2 expression, whereas 78 of the 106 (74%) Bax-immunopositive tumors had low Bcl-2 expression. By itself, Bax expression was not of prognostic significance in univariate analysis, although there was a clear trend for patients with Bax-immunonegative lymphomas (n = 7) to relapse sooner and to die faster than patients whose tumors contained Bax-immunopositive malignant cells (n = 106; 8-year overall survival 29% versus 55%; P = .06). When combined with Bcl-2 immunostaining data, Bax provided additional prognostic information. Among patients with Bcl-2 low-expressing DLCLs, for example, Bax immunonegativity was associated with lower 8-year relapse-free survival (RFS; 29% v 61%; P < .01) and lower 8-year overall survival (OS; 29% v 63%; P < .05), suggesting that absence of Bax protein connotes a more aggressive phenotype when Bcl-2 protein is also not expressed at high levels. In contrast, low Bax expression was associated with improved 8-year disease-free survival (52% v 16%; P < .02), RFS (47% v 11%; P < .02), and OS (64% v 11%; P < .01) in patients whose tumors expressed Bcl-2 at high levels, suggesting that the combination of high levels of Bax and Bcl-2 expression is more deleterious than high levels of Bcl-2 expression alone. Bax expression failed to provide additional prognostic information beyond Bcl-2 expression in multivariate analysis that included the clinical International Prognostic Index factors (age, stage, lactate dehydrogenase, performance status, and number of extranodal sites) and immunophenotype. Taken together, the results suggest that Bax expression is not a major prognostic marker in DLCL. However, the interactions of the Bcl-2 and Bax expression data with respect to clinical outcome may shed new insights into the biological significance of Bcl-2/Bax protein heterodimerization.

Adolescent↗

PubMed1997

Value of Ki-67 immunolabelling as a prognostic factor in prostate cancer.

OBJECTIVE(S): The aim of the study was to analyze the results of Ki-67 immunostaining in prostatic adenocarcinoma and to assess its prognostic value. METHODS: Clinical follow-up data was reviewed in 190 prostatic adenocarcinomas and the results of Ki-67 immunolabelling were correlated to standard prognostic factors and survival data of the patients. All stage and grade categories were included. RESULTS: Ki-67 expression correlated significantly with histological differentiation of tumors, indicators of cell proliferation, perineural growth, density of tumor-infiltrating lymphocytes and TM classification. In survival analysis, Ki-67 expression was able to discriminate patients into different prognostic groups (p = 0.0035). In a separate analysis including T1-2M0 tumors, Ki-67 immunolabelling was a significant predictor of survival (p = 0.0258). In Cox's multivariate analysis Ki-67 was an independent prognostic factor in the entire cohort. CONCLUSIONS: The results show that Ki-67 expression is a potentially useful prognostic factor in prostatic adenocarcinoma and it could be used as an additional criterion in defining a correct prognostic category in this malignancy.

Adenocarcinoma↗

PubMed1998

Expression of CD44 variant exon 6 in stage I non-small cell lung carcinoma as a prognostic factor.

Specific CD44 isoforms are the surface adhesion molecules that have been shown to be associated with metastasis. In the present study, the role of the expression of standard and variant CD44 isoform (CD44s and CD44v6) as prognostic indicators in pathological stage I non-small cell lung carcinoma was investigated immunohistologically using monoclonal antibodies. The results showed that the expression of CD44v6 correlates with adverse prognosis in stage I non-small cell lung carcinoma but not CD44s. The 5-year survival rate of the patients with CD44v6-positive tumors was 50%, which was significantly lower than that of CD44v6-negative patients (88%; P = 0.001). The incidence of recurrent distant metastasis in the CD44v6-positive patients (45%; 9 of 20 patients) was significantly higher than that in the CD44v6-negative patients (20%; 10 of 49 patients; P = 0.038), suggesting the involvement of CD44v6 in hematogeneous metastasis of lung carcinoma. Although the incidence of the expression of CD44v6 in squamous cell carcinoma was significantly higher than that in adenocarcinoma, histological type was not a significant prognostic factor. No significant correlation was found between the expression of CD44v6 and lymphatic or vascular vessel invasion, although lymphatic vessel invasion was found to be an independent prognostic factor in the multivariate analysis. To investigate the relationship between the expression of CD44v6 and proliferative activity of tumor cells, the expression of proliferating cell nuclear antigen (PCNA) was examined. The expression of CD44v6 was more frequently observed in PCNA-positive patients than in PCNA-negative patients (P = 0.019), but the expression of PCNA was not a statistically significant prognostic indicator. The results of multivariate analysis by the Cox proportional hazards model showed that CD44v6 was an independent prognostic indicator. We concluded that the expression of CD44v6 is a useful prognostic factor in stage I non-small cell lung carcinoma.

Carcinoma, Non-Small-Cell Lung↗