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At least 811 records · Page 45Linked to original sources
PubMed1998

Detection of germ cell tumor cells in apheresis products using polymerase chain reaction.

The contamination of apheresis products with tumor cells was evaluated in patients undergoing autologous peripheral blood stem cell transplantation for germ cell tumors. A blinded, retrospective analysis was performed on 63 apheresis products from 28 patients using the PCR and primers for beta human chorionic gonadotropin (beta-HCG). Of the 20 patients with beta-HCG-secreting tumors, 8 apheresis products from 7 patients were PCR positive. PCR was negative in the 8 patients whose tumors did not secrete beta-HCG. Twenty-two apheresis products from patients with lymphoma and breast cancer were negative for beta-HCG expression. Evaluating the 20 patients with beta-HCG-secreting tumors, 100% of PCR-positive patients had elevated serum beta-HCG at the time of apheresis compared to 46.2% of PCR-negative patients (P = 0.04). A positive PCR was also associated with a higher serum beta-HCG at diagnosis (P = 0.03). Patients receiving a PCR-positive product had a higher relapse rate (85.7 versus 61.5%) and were more likely to have visceral metastasis (100 versus 61.5%), although the numbers did not reach statistical significance (P = 0.35 and 0.11, respectively). The finding of beta-HCG mRNA in apheresis products strongly suggests the presence of circulating tumor cells in a significant number of germ cell patients undergoing autologous transplantation. This assay may be useful in monitoring attempts at tumor cell depletion and in developing improved prognostic models for assessing risk of relapse after transplantation.

Blood Component Removal↗
PubMed1998

[Role of autologous stem cell transplantation in the treatment of Hodgkin's lymphoma].

Among lymphomas, treatment of Hodgkin's disease (HD) allows the highest cure-rate. Radiotherapy (RT) represents first choice therapy in early stages, providing complete remission (CR) rate even superior to 90%. Chemotherapy (CHT) or, when indicated, the combined modality treatment (CHT + RT) is successful, in terms of long overall survival (> 10 yrs) in more than 60% of patients with advanced stage disease at onset. Considering all stages of disease at onset, about 75% of patients can be cured. However, the remaining 25% results resistant to the conventional approach (CHT +/- RT) or, mainly, relapses after first CR. For these poor prognosis patients, it has been assessed the possibility of inducing (or reinducing) a CR by using high dose CHT with stem cells rescue. Autologous stem cell transplantation (ASCT) consists in the administration of antiblastic drugs at so high dosages to require the consequent reinfusion of stem cells, preventively harvested and cryopreserved, thus dramatically decreasing the risk of a prolonged bone marrow aplasia. This procedure is currently performed as intensification treatment in selected cases of patients with advanced stage at onset, once in CR after first-line therapy. Therefore, the development of prognostic models aimed to define with higher sensibility and specificity patients at high risk of relapse and to be submitted to ASCT as consolidation therapy, is becoming of increasing interest.

Adult↗
PubMed1998

Liver transplantation for cholestatic liver disease: screening and assessment of risk factors.

Orthotopic liver transplantation for primary biliary cirrhosis and primary sclerosing cholangitis is a well-accepted therapy for complications of end-stage liver disease and is associated with an excellent outcome in the majority of cases. However, transplant centers are striving to improve on these outcomes by studying ways to optimize the timing of transplantation. Several natural history and prognostic models for both primary biliary cirrhosis and primary sclerosing cholangitis have been derived from the study of large populations of patients in an attempt to predict long-term rates of survival. In addition, models exist to predict resource utilization after liver transplantation. Other factors besides complications of end-stage liver disease may also be indications for transplantation, including refractory pruritus, recurrent bacterial cholangitis in patients with primary sclerosing cholangitis, hepatic osteodystrophy, and a poor quality of life.

Cholangitis, Sclerosing↗
PubMed1998

Transplantation for alcoholic liver disease: a perspective from Europe.

It is now accepted that patients who receive a liver transplant for alcohol-related liver disease have a rate of survival similar to those who receive grafts for other indications. Abstinence from alcohol before liver transplantation is important in ensuring that the liver will not recover, but the period of abstinence required before transplantation is undertaken is uncertain. Prognostic models for assessing patients with alcoholic liver disease have been developed but correlate poorly with each other. A return to alcohol consumption after transplantation is not uncommon, although graft failure or damage is uncommon. However, alcohol-related liver disease is becoming an increasing indication for liver transplantation. As the number of potential candidates exceeds the supply of donors, some form of rationing will be required. The general public places a lower priority on transplantation for alcoholic liver disease than for other indications, and this will need to be considered by those who allocate the donor livers.

Acute Disease↗
PubMed2001

Incorporating biologic measurements (SF(2), CFE) into a tumor control probability model increases their prognostic significance: a study in cervical carcinoma treated with radiation therapy.

PURPOSE: To assess whether incorporation of measurements of surviving fraction at 2 Gy (SF(2)) and colony-forming efficiency (CFE) into a tumor control probability (tcp) model increases their prognostic significance. METHODS AND MATERIALS: Measurements of SF(2) and CFE were available from a study on carcinoma of the cervix treated with radiation alone. These measurements, as well as tumor volume, dose, and treatment time, were incorporated into a Poisson tcp model (tcp(alpha,rho)). Regression analysis was performed to assess the prognostic power of tcp(alpha,rho) vs. the use of either tcp models with biologic parameters fixed to best-fit estimates (but incorporating individual dose, volume, and treatment time) or the use of SF(2) and CFE measurements alone. RESULTS: In a univariate regression analysis of 44 patients, tcp(alpha,rho) was a better prognostic factor for both local control and survival (p < 0.001 and p = 0.049, respectively) than SF(2) alone (p = 0.009 for local control, p = 0.29 for survival) or CFE alone (p = 0.015 for local control, p = 0.38 for survival). In multivariate analysis, tcp(alpha,rho) emerged as the most important prognostic factor for local control (p < 0.001, relative risk of 2.81). After allowing for tcp(alpha,rho), CFE was still a significant independent prognostic factor for local control, whereas SF(2) was not. The sensitivities of tcp(alpha,rho) and SF(2) as predictive tests for local control were 87% and 65%, respectively. Specificities were 70% and 77%, respectively. CONCLUSIONS: A Poisson tcp model incorporating individual SF(2), CFE, dose, tumor volume, and treatment time was found to be the best independent prognostic factor for local control and survival in cervical carcinoma patients.

Carcinoma, Squamous Cell↗
PubMed2004

A strategy for health surveillance in laboratory animal workers exposed to high molecular weight allergens.

AIMS: To develop a health surveillance strategy with the use of diagnostic and prognostic prediction models to detect and predict occupational allergic diseases efficiently. METHODS: Data from laboratory animal workers (n = 351) participating in an ongoing cohort study were used to develop diagnostic and prognostic models with logistic regression analyses. A diagnostic model was developed from questionnaire items, and exposure measurements to find predictors for the estimation of the probability of sensitisation to workplace allergens. With the resulting questionnaire model workers were divided into subgroups (high/low probability). A prognostic model was established in workers initially low sensitised using follow up data over a 2-3 year period. The accuracy of the models was evaluated by the concordance (c) statistic, and by comparison of the predicted and observed prevalence. RESULTS: A diagnostic rule, containing five questionnaire items, identified workers with a high risk of sensitisation. These workers showed high rates of work related asthma, allergic symptoms, doctor's visit, and absenteeism. A prognostic rule based on four questionnaire items predicted workers at high risk of near future sensitisation with high rates of future (allergic) respiratory symptoms, and asthmatic attacks. CONCLUSION: The risk of (future) sensitisation and the severity of laboratory animal allergy can be predicted accurately with diagnostic and prognostic prediction models based on questionnaire items. Workers with an increased risk of future sensitisation also showed serious allergic symptoms at follow up. Workers with a low risk have a low risk of becoming diseased in the future.

Allergens↗
PubMed2026

Refining the Multivariable Predictive-Prognostic PREDICTR-OPC Model for Survival in Surgical Escalation for Oropharyngeal Squamous Cell Carcinoma.

OBJECTIVES: The PREDICTR-OPC model is the only prognostic classifier for oropharyngeal squamous cell carcinoma (OPSCC) also predictive of surgical outcomes. Of the four biomarkers included, survivin contributes minimally and presents practical limitations. This study aimed to refine and simplify the model by removing survivin, then re-assess its prognostic predictive performance compared to the original. METHODS: This retrospective cohort study analyzed a multi-center training cohort (n&#x2009;=&#x2009;600) and an external validation cohort (n&#x2009;=&#x2009;385) of OPSCC patients. Tumor biopsies were stained for p16, high-risk human papillomavirus (HR-HPV) DNA, tumor-infiltrating lymphocytes (TILs), and survivin and independently scored by at least three certified pathologists. Cox proportional hazards models assessed overall survival (OS), comparing three-biomarker (p16, HR-HPV, TILs) and four-biomarker models. Hazard ratios (HRs) for OS were estimated in the validation cohort, adjusting for covariates. Discrimination, calibration, and decision curve analysis (DCA) evaluated performance and clinical utility. RESULTS: Among 985 patients (median age: 57&#x2009;years), median OS&#x2009;=&#x2009;8.8&#x2009;years (95% CI: 6.9-10.5). The three-biomarker model yielded HR&#x2009;=&#x2009;4.10 (95% CI: 2.41-6.98, p&#x2009;<&#x2009;0.001) for high- vs. low-risk groups in the validation cohort, comparable to the four-biomarker model (HR&#x2009;=&#x2009;4.24, p&#x2009;<&#x2009;0.001). Surgery was associated with improved OS in high-risk (HR&#x2009;=&#x2009;0.45, p&#x2009;=&#x2009;0.001) but not low-risk (HR&#x2009;=&#x2009;0.83, p&#x2009;=&#x2009;0.72) patients, consistent with the original model. The models performed similarly across all metrics (e.g., Concordance Index: 0.71 vs. 0.72; Brier Score: 0.22 for both) as was model fit (Likelihood Ratio Test: p&#x2009;=&#x2009;0.066). DCA revealed comparable clinical benefit. CONCLUSION: Removing survivin preserves PREDICTR-OPC's predictive performance, offering a more cost-effective, easier-to-implement tool for OPSCC treatment recommendations.

Humans↗
PubMed2005

Environmental prognostics: an integrated model supporting lysosomal stress responses as predictive biomarkers of animal health status.

The potential prognostic use of lysosomal reactions to environmental pollutants is explored in relation to predicting animal health in marine mussels, based on diagnostic biomarker data. Cellular lysosomes are already known to accumulate many metals and organic xenobiotics and the lysosomal accumulation of the carcinogenic polycyclic aromatic hydrocarbon 3-methylcholanthrene (3-MC) is demonstrated here in the hepatopancreatic digestive cells and ovarian oocytes of the blue mussel. Lysosomal membrane integrity or stability appears to be a generic indicator of cellular well-being in eukaryotes; and in bivalve molluscs it is correlated with total oxygen and nitrogen radical scavenging capacity (TOSC), protein synthesis, scope for growth and larval viability; and inversely correlated with DNA damage (micronuclei), as well as lysosomal swelling (volume density), lipidosis and lipofuscinosis, which are all characteristic of failed or incomplete autophagy. Integration of multiple biomarker data is achieved using multivariate statistics and then mapped onto "health status space" by using lysosomal membrane stability as a measure of cellular well-being. This is viewed as a crucial step towards the derivation of explanatory frameworks for prediction of pollutant impact on animal health; and has facilitated the development of a conceptual mechanistic model linking lysosomal damage and autophagic dysfunction with injury to cells, tissues and the whole animal. This model has also complemented the creation and use of a cell-based bioenergetic computational model of molluscan hepatopancreatic cells that simulates lysosomal and cellular reactions to pollutants. More speculatively, the use of coupled empirical measurements of biomarker reactions and modelling is proposed as a practical approach to the development of an operational toolbox for predicting the health of the environment.

Animal Structures↗
PubMed2002

Identification of objective pathological prognostic determinants and models of prognosis in Dukes' B colon cancer.

BACKGROUND AND AIMS: There is a need for objective easily determined pathological prognostic parameters in Dukes' B colon carcinoma to allow selection of such patients for further treatment as the role of adjuvant chemotherapy for these patients remains unclear. This study was initiated to assess the influence of pathological factors on prognosis in an unselected prospective series of Dukes' B colonic cancer. METHODS: The Gloucester Colorectal Cancer study, established in 1988, recruited more than 1000 cases. Meticulous pathological assessment of the 268 Dukes' B colonic cancer resections in this series included evaluation of all pathological factors that could influence staging and prognosis. All patients entered a comprehensive follow up system. RESULTS: Four pathologically determined factors--peritoneal involvement, venous spread (both submucosal and extramural), spread to involve a surgical margin, and perforation through the tumour-were independent prognostic factors in multivariate analysis. Combining these four factors into a simple cumulative scoring system generated clinically useful prognostic groups. CONCLUSIONS: The cumulative prognostic index allows apportionment of patients with Dukes' B colon cancer into defined prognostic groups, which in turn could allow more objective selection of patients for adjuvant therapy, especially as part of clinical trials.

Adult↗
PubMed1999

A multivariate model to determine prognostic factors in gastrointestinal fistulas.

BACKGROUND: Some studies have identified and selected factors that were associated with prognosis in patients with gastrointestinal fistulas, but a multivariate analysis to determine their relative importance and independent predictive value has not been done. The aim of this study was to determine independent prognostic factors for fistula closure and death in patients with gastrointestinal fistulas using a multivariate model. STUDY DESIGN: Several variables were assessed related to spontaneous closure, surgical closure, and mortality in 188 patients with digestive fistulas (duodenal 22.3%, jejunoileal 28.7%, colonic 23.9%, biliopancreatic 25%). Selection of the variables was done through a forward stepwise logistic regression procedure; the final models were used to estimate the probability of closure, either spontaneous or surgical, and the probability of death. RESULTS: Variables significant for spontaneous closure were: cause of the fistula (p = 0.027), fistula output (p = 0.037), institutional origin of the patient (p = 0.026), and occurrence of complications (p<0.001). Organ of origin of the fistula was only marginally significant (p = 0.068). Successful surgical closure was significantly associated with the presence of complications (p = 0.001) and was marginally associated with age (p = 0.069). Variables significant for death were fistula output (p = 0.009) and the presence of complications (p<0.001). CONCLUSIONS: We conclude that the likelihood of spontaneous fistula closure is higher for fistulas with surgical causes, low output, and with no complications. Mortality is higher in patients with complications and with high-output fistulas.

Adult↗
PubMed1996

Multilevel models for longitudinal variables prognostic for survival.

The issue of modelling the joint distribution of survival time and of prognostic variables measured periodically has recently become of interest in the AIDS literature but is of relevance in other applications. The focus of this paper is on clinical trials where follow-up measurements of potentially prognostic variables are often collected but not routinely used. These measurements can be used to study the biological evolution of the disease of interest; in particular the effect of an active treatment can be examined by comparing the time profiles of patients in the active and placebo group. It is proposed to use multilevel regression analysis to model the individual repeated observations as function of time and, possibly, treatment. To address the problem of informative drop-out--which may arise if deaths (or any other censoring events) are related to the unobserved values of the prognostic variables--we analyse sequentially overlapping portions of the follow-up information. An example arising from a randomized clinical trial for the treatment of primary biliary cirrhosis is examined in detail.

Bilirubin↗
PubMed1996

[The most important prognostic factors for 736 patients with adenocarcinoma of the gastric cardia: a multivariate analysis using COX proportion hazard model].

A prognostic study was done in 736 patients with primary resectable adenocarcinoma of the gastric cardia whose postoperative survival time was longer than three months. The 3-, 5-, and 10-year cumulative survival rate was 32.2%, 20.2% and 12.2%, respectively. Thirty individual variables were evaluated statistically using the cumulative survival rate by the computer's COX multivariate analysis model. The results showed that the most important prognostic variables for predicting overall survival included maximal tumor diameter, type of resection, depth of invasion and paracardial lymph node metastasis. Sex and preoperative radiotherapy did not influence prognosis.

Adenocarcinoma↗
PubMed2004

Can inclusion of serum creatinine values improve the Child-Turcotte-Pugh score and challenge the prognostic yield of the model for end-stage liver disease score in the short-term prognostic assessment of cirrhotic patients?

BACKGROUND: The model for end-stage liver disease (MELD) score is a useful tool to assess prognosis in critically ill cirrhotic patients. However, its short-term prognostic superiority over the traditional Child-Turcotte-Pugh (CTP) score has not been definitely confirmed. The creatinine serum level is an important predictor of survival in patients with liver cirrhosis. AIMS: To evaluate and compare the short-term prognostic accuracy of the CTP, the creatinine-modified CTP, and the MELD scores in patients with liver cirrhosis. METHODS: CTP, creatinine-modified CTP, and MELD scores were calculated in a cohort of 145 cirrhotic patients. The creatinine-modified CTP was calculated as follows: we assessed the mean creatinine serum level and standard deviation (SD) of the 145 study patients, then assigned a score of 1 to patients with creatinine serum levels < or = to the mean, a score of 2 to patients with creatinine levels between the mean and the mean+1 SD, and a score of 3 to patients with creatinine levels above the mean+1 SD. The creatinine-modified CTP was then calculated by simply adding each patients' creatinine score to their traditional CTP scores. We calculated and compared the accuracy (c-index) of the three parameters in predicting 3-month survival. RESULTS: The creatinine-modified CTP score showed better prognostic accuracy as compared with the traditional CTP (P=0.049). However, the MELD score proved to be better at defining patients' prognosis in the short-term as compared with both the traditional CTP score (P=0.012) and the creatinine-modified CTP (P=0.047). The excellent short-term prognostic accuracy of the MELD score was confirmed even when patients with abnormal creatinine serum levels were excluded from the analysis (c-index=0.935). CONCLUSIONS: Adding creatinine values to the CTP slightly improves the prognostic usefulness of the traditional CTP score alone. The MELD score has a short-term prognostic yield that is better than what is provided by both the CTP and CTP creatinine-modified scores, even in cirrhotic patients who are not critically ill. The positive results obtained by using the MELD score were confirmed even after excluding patients with impaired renal function.

Aged↗
PubMed2026

A model of cellular proliferation and mitochondrial biogenesis predicts prognosis and immunotherapy response in lung adenocarcinoma.

BACKGROUND: Lung adenocarcinoma (LUAD), which is the leading subtype of non-small cell lung cancer (NSCLC), poses considerable difficulties in accurate prognostic assessment and targeted therapeutic options. Cell proliferation-related genes (CPGs) and mitochondrial biogenesis-related genes (MBGs) play critical roles in tumor metabolic reprogramming; however, their prognostic value and molecular mechanisms in LUAD are poorly understood. This study aims to construct a CPG/MBG-based prognostic risk model for LUAD, evaluate its clinical utility in predicting prognosis and immunotherapy response, and experimentally validate the functional role of key model genes in LUAD progression. METHODS: By utilizing The Cancer Genome Atlas (TCGA)-LUAD and GSE72094 datasets, this investigation formulated a risk scoring model through differential expression screening combined with least absolute shrinkage and selection operator (LASSO)-Cox regression analysis. The molecular characteristics and clinical implications of the risk model were investigated via immune microenvironment evaluation, genomic alteration analysis, and drug sensitivity prediction. The functional contributions of key genes were further substantiated using quantitative reverse transcription polymerase chain reaction (qRT-PCR), commercial assay kits, the JC-1 fluorescent probe, the Cell Counting Kit-8 (CCK-8), Transwell invasion assays, and wound healing assays. RESULTS: A risk model based on seven CPGs and MBGs (PLK1, HMMR, CYP27A1, LDHA, NPAS2, KRT17, CIDEC) showed reliable predictive performance in both GSE72094 and the TCGA-LUAD cohorts. Enhanced tumor heterogeneity and an immunosuppressive microenvironment were observed in the high-risk group. Drug sensitivity analysis indicated that the risk model could guide personalized treatment strategies; for instance, high-risk patients showed increased susceptibility to agents such as docetaxel and 5-fluorouracil. In vitro experiments demonstrated that the key gene CIDEC exhibited upregulated expression in LUAD tissues and cells. Knockdown of CIDEC led to enhanced cellular energy metabolism and increased mitochondrial membrane potential, while also effectively suppressing cell invasion, proliferation, and migration. CONCLUSIONS: The established MBGs/CPGs prognostic model provides a novel tool for stratified treatment planning in LUAD, underscoring the crucial roles of cellular proliferation and mitochondrial biogenesis in tumor progression. Functional validation of CIDEC offers experimental support for the development of potential therapeutic strategies.

Lung adenocarcinoma (LUAD)↗
PubMed1998

Statistical modeling using preoperative prognostic variables in predicting extracapsular extension and progression after radical prostatectomy for prostate cancer.

OBJECTIVE: To predict the risk of extracapsular extension and postoperative recurrence before radical prostatectomy (RP) for prostate cancer. METHODS: We performed multivariate Cox regression analysis on preoperative variables in 260 clinically localized prostate cancer patients who underwent RP. With these data, we constructed a relative risk of recurrence (Rr) equation and an equation to predict the probability of extracapsular extension (PECE) before RP. RESULTS: Rr is calculated as exp[(0.47 x race + 0.14 x PSAST) + (0.13 x worst biopsy Gleason sum) + (1.03 x stage T1c) + (1.55 x stage T2b,c)], where PSAST indicates a sigmoidal transformation of prostate-specific antigen. PECE is calculated as 1/[1 + exp(-Z)], where Z = -2.47 + 0.15 (PSAST) + 0.31 (worst biopsy Gleason sum) + 0.18 (race) + 0.16 (stage T1c) + 0.38 (stage T2b,c). CONCLUSION: These two equations can be used preoperatively to predict the probability of extracapsular disease and the risk of prostate-specific antigen recurrence in patients undergoing RP.

Aged↗
PubMedDate not supplied

[Prognostic radioecological mathematical model of the Yenisei river].

A one-dimensional mathematical model of the Yenisei river ecosystem including hydrological, ecosystem and radioecological blocks has been developed. The model was used to evaluate contribution of different processes (transfer by water masses, dilution, radioactive decay, bioaccumulation) into self-purification of the river water from a radiation pollution and calculate pollution density of ecosystem components (bacteria, phyto-, zooplankton, phyto-, zoobenthos, detritus) with 137Cs and 32P.

Ecosystem↗