Category: Statistics

J BUON. 2021 Jul-Aug;26(4):1466-1478.

ABSTRACT

PURPOSE: The purpose of our work was to investigate the association between proliferative index [proIDX] and expression index p53 (p53IDX) with the clinical and pathological characteristics of gastric adenocarcinoma.

METHODS: The biopsy material of 90 patients operated on for gastric cancer was routinely processed in paraffin and archived. After the histopathological report was made, two study groups were formed, the first group (n=45) comprised biopsies with intestinal carcinoma and the second (n=45) biopsies of diffuse gastric cancer. In both cases, the control group consisted of biopsies of surrounding non-tumor tissue The routine Hematoxylin-Eosin and immunohistochemical ABC method with anti-Ki67 and anti-p53 antibodies was applied at sections 3-5 μm thick. The expression of Ki67 and p53 was quantified stereometrically. For statistical analysis SPSS (19.0) was used.

RESULTS: Significantly higher Ki67 expression was found in both types of adenocarcinoma compared to the control group, as well as significant association of proIDX with most of testing parameters. Expression of p53 was significantly higher in the intestinal type compared to the diffuse type and the control group and was significantly associated with age and histological grade. Diffuse type particulary showed, significant association of p53IDX with most of the histological parameters tested.

CONCLUSION: Our results point a highly significant correlation of the Ki67 and p53 expression with indicators of gastric adenocarcinoma progression, which may help to identify patients with an aggressive gastric adenocarcinoma phenotype.

PMID:34565006

J BUON. 2021 Jul-Aug;26(4):1479-1484.

ABSTRACT

PURPOSE: To explore the effect of multi-slice spiral computed tomography (MSCT) enhanced scan image diagnosis on clinical outcome of patients after radical gastrectomy and its influence on misdiagnosis rate.

METHODS: A total of 62 patients diagnosed with gastric cancer and undergoing radical gastrectomy were selected. All patients were reexamined 2-6 months after operation. Conventional CT and MSCT enhanced scan were performed for image diagnosis, and the results were compared with those of gastroscopic biopsy. Finally, the misdiagnosis rate, negative predictive value, positive predictive value, sensitivity and specificity of conventional CT and MSCT enhanced scan for postoperative recurrence were analyzed.

RESULTS: According to the results of gastroscopic biopsy, there were 35 cases suspected of recurrence, and 27 cases without postoperative recurrence. The specificity and sensitivity of conventional CT and MSCT enhanced scan were 85.19% vs. 92.59%, and 65.71% vs. 92.16%, respectively. Both specificity and sensitivity of MSCT enhanced scan were higher than those of conventional CT, with statistically significant differences (p<0.05). MSCT enhanced scan had a lower misdiagnosis rate for postoperative recurrence than conventional CT (5.71% vs. 22.86%) (p<0.05). Moreover, the negative predictive value and positive predictive value of conventional CT and MSCT enhanced scan were 65.71% vs. 86.21%, and 85.19% vs. 93.94%, respectively. The results showed that MSCT enhanced scan had higher negative predictive value and positive predictive value for postoperative recurrence than conventional CT, with statistically significant differences (p<0.05).

CONCLUSION: MSCT enhanced scan image diagnosis is of great significance for assessing the condition of disease, determining the recurrent foci after radical gastrectomy, and developing the subsequent therapeutic regimen.

PMID:34565007

J BUON. 2021 Jul-Aug;26(4):1415-1421.

ABSTRACT

PURPOSE: To explore the laboratory indexes related to breast cancer metastasis, so as to provide scientific basis for the control of breast metastasis.

METHODS: A retrospective cohort-based nested case-control study was used to screen 732 breast cancer patients recorded in the First and the Third Hospitals of Jilin University’s electronic medical record system between January 2008 through December 2015 without metastasis at admission. Those with subsequent metastasis were classified as the metastasis group and those without metastasis as the control group. The suspected confounders were matched by propensity score matching, then univariate analysis was conducted, and the variables with statistical significance were included in multivariate conditional logistic regression analysis.

RESULTS: A total of 86 patients were matched in the transfer group and 315 in the control group, with a total sample size of 401.In univariate analysis, fasting plasma glucose (FPG), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) and direct bilirubin (DBIL) in two groups were statistically different (p<0.05), multiple conditional logistic regression showed that FPG (OR=1.335) and ALP (OR=1.016) were factors related to breast cancer metastasis.

CONCLUSIONS: For breast cancer patients, the higher FPG and ALP levels may be associated with metastasis. Therefore, daily monitoring and control of these indicators may be helpful for the control of cancer metastasis.

PMID:34564999

J BUON. 2021 Jul-Aug;26(4):1453-1459.

ABSTRACT

PURPOSE: To investigate the short- and medium-term outcomes following treatment with uniportal video-assisted thoracic surgery lobectomy (uniportal VATS) in elderly patients with non-small cell lung cancer (NSCLC).

METHODS: We conducted a retrospective analysis on the clinical and follow-up data of 74 elderly patients with NSCLC who underwent uniportal VATS between January 2015 and January 2020. One-to-one propensity score matching (PSM) was employed to select 71 elderly patients with NSCLC who underwent multiportal video-assisted thoracoscopic lobectomy (multiportal VATS) during the same period.

RESULTS: The baseline characteristics of the two patient groups were comparable, with no statistically significant differences in postoperative complications, operation time, conversion to thoracotomy, or lymph node dissection. The amount of intraoperative blood loss and postoperative pain were lower in the uniportal VATS group than in the multiportal VATS group. The 3-year overall survival and disease-free survival of the two groups were similar.

CONCLUSIONS: Uniportal VATS achieved similar short- and medium-term outcomes as Multiportal VATS in elderly patients with NSCLC.

PMID:34565004

J BUON. 2021 Jul-Aug;26(4):1398-1404.

ABSTRACT

PURPOSE: Recently, neoadjuvant treatment approach has gained importance in locally advanced HER-2 positive breast cancer. Adding pertuzumab increases pathological complete response (pCR). In this study, we aimed to examine the clinicopathologic features that predict the pCR in patients receiving neoadjuvant pertuzumab, trastuzumab, and chemotherapy in locally advanced HER2 positive breast cancer.

METHODS: Locally advanced HER2 positive breast cancer patients who were followed up in 4 different oncology centers and received 4 cycles of pertuzumab, trastuzumab and taxane were retrospectively evaluated. A total of 58 (92%) patients received anthracycline chemotherapy before combination of dual her-2 blockade and taxanes. Fisher’s and chi-square tests were used for nominal variables and numeric data analyses.

RESULTS: A total of 63 female patients were included in the study. Their median age was 46 years (21-75) and 40 (63.5%) patients were premenopausal. Median tumor size was 25 mm (2-70) and there were 22 (34.9%) patients with Stage 3a. pCR was 66% and 75% in the whole group and in the hormone negative group, respectively. Statistically significant increase was found in pCR in patients with grade 3 tumors and cerbB2 with 3+ immunohistochemical staining. No relationship was found between pCR and age at diagnosis, menopausal status, tumor infiltrating lymphocyte, dose-dense anthracycline, Ki67≥40, body mass index (BMI) ≥ 30 kg/m2 and accompanying DCIS.

CONCLUSION: Four cycles of pertuzumab, trastuzumab and taxane after neoadjuvant anthracycline for locally advanced HER2 breast cancer are associated with increased pCR in patients with grade 3 tumors and high cerbB2 expression.

PMID:34564997

J BUON. 2021 Jul-Aug;26(4):1405-1414.

ABSTRACT

PURPOSE: The COVID-19 pandemic has changed the way many health institutions approach their workload. Physicians managing patients with cancer now have to deal not only with the disease but also the restrictions and limitations imposed because of the global pandemic. We aimed to determine how surgical preferences in breast cancer management were affected globally using a questionnaire-based survey.

METHODS: Under the auspices of the Turkish Senology Society (SENATURK) we asked 122 surgeons from 27 countries to reply to a 26-question survey designed to measure the impact of COVID-19 on their surgical practice when treating patients with breast cancer.

RESULTS: The characteristics of participant surgeons were statistically similar when comparing the participants’ answers from Turkey and other countries. From the responses given to our questionnaire, it was understood that breast cancer surgery decreased by 25% (p<0.05) in institutions all over the world, including Turkey, but there was no change in the approach technique to the axilla.

CONCLUSIONS: Globally breast surgeons have adapted to the new normal due to the COVID-19 pandemic. Many surgical approaches and some follow up protocols have been changed, although the degree of change has varied from country to country. In addition, the availability of multidisciplinary case conferences has been reduced in some centers which may affect the quality of services provided to patients.

PMID:34564998

J BUON. 2021 Jul-Aug;26(4):1298-1305.

ABSTRACT

PURPOSE: We aimed to evaluate the efficacy and safety of helical tomotherapy (HT) combined with computed tomography (CT)-guided three-dimensional intracavitary brachytherapy (CT-ICBT) in the treatment of locally advanced cervical cancer.

METHODS: A total of 96 patients with locally advanced cervical cancer (IIB-IIIB) treated were retrospectively analyzed. They underwent concurrent radiochemotherapy, and the chemotherapy regimen paclitaxel + cisplatin was given for 3 weeks. The patients were divided into HT+CT-ICBT group (n=48) and intensity-modulated radiotherapy (IMRT) + two-dimensional ICBT (IMRT+ICBT group, n=48) according to the different extracorporeal and intracavitary radiotherapies. The short-term clinical efficacy, and short- and long-term adverse reactions were compared between the two groups, the tumor recurrence and survival status were recorded through follow-up, and the overall survival (OS) and progression-free survival (PFS) rates were compared between the two groups.

RESULTS: The patient general clinical characteristics were comparable in both groups. The short-term clinical effective rate was 91.7% (44/48) and 87.5% (42/48), respectively, in HT+CT-ICBT group and IMRT+ICBT group. In the two groups, the incidence rate of grade 3-4 chronic radiation proctitis was 4.2% (2/48) and 22.9% (11/48), while that of grade 3-4 chronic radiation cystitis was 2.1% (1/48) and 18.7% (9/48), respectively. According to the follow-up results, the 3-year OS was 85.4% (41/48) and 77.1% (37/48), and the 3-year PFS was 81.3% (39/48) and 70.8% (34/48), respectively, in the two groups. Log-rank test showed that the 3-year OS and PFS had no statistically significant differences (p=0.395, p=0.401).

CONCLUSION: HT+CT-ICBT is safe and effective in the treatment of locally advanced cervical cancer, and it has similar short-term clinical efficacy and long-term survival rate compared with IMRT+ICBT, which also significantly reduces the long-term incidence of radiation proctitis and cystitis, so it is worthy of popularization and application.

PMID:34564984

J BUON. 2021 Jul-Aug;26(4):1373-1378.

ABSTRACT

PURPOSE: The objective of this study was to investigate the therapeutic effect and safety of three-dimensional digital subtraction angiography (3D-DSA) in interventional therapy for hepatocellular carcinoma (HCC) patients.

METHODS: A total of 62 HCC patients who underwent interventional therapy were selected and divided into control group (n=31, receiving ordinary two-dimensional DSA) and observation group (n=31, undergoing 3D-DSA). The dosage of contrast agent, operation time and exposure dose were compared between the two groups. Besides, the effective rate, success rate of superselective arterial catheterization, lipiodol deposition rate and the incidence rate of complications of the two groups were observed and recorded.

RESULTS: Compared with those in control group, the dose of contrast agent and exposure dose were lower in observation group, and the operation time in the former was significantly shorter than that in the latter. The effective rate was 74.19% in observation group and 48.39% in control group. Moreover, in comparison with control group, operation group exhibited a higher effective rate, a higher success rate of superselective arterial catheterization and a higher lipiodol deposition rate, showing statistically significant differences (p<0.05). Besides, the incidence rate of complications (including myelosuppression, gastrointestinal discomfort and infection, 4.88%) in observation group was markedly lower than that in control group (25.81%) (p<0.05).

CONCLUSION: 3D-DSA under contrast guidance during interventional treatment of patients with HCC can significantly improve the therapeutic effect, and it is of great importance to reduce the incidence rate of complications and enhance the safety of interventional treatment.

PMID:34564994

J BUON. 2021 Jul-Aug;26(4):1226-1230.

ABSTRACT

PURPOSE: The purpose of this study was to explore the clinical diagnostic value of combined detection of multiple tumor markers (CEA, CA242, CA19.9 and CA125) and blood lipid indexes in colorectal cancer, and to analyze their predictive effect on adverse reactions after chemotherapy.

METHODS: The clinical data of 35 patients with colorectal adenoma, 64 patients with colorectal cancer I-II and 29 patients with colorectal cancer III-IV were retrospectively analyzed. All the patients were admitted to our hospital from April 2017 to December 2019. The antigen level of tumor markers and the plasma level in patients were detected before surgery to compare the expression difference of different tumor types. The Youden index, sensitivity and specificity of the four tumor markers were compared when used alone or in combination.

RESULTS: After one year of follow-up, the levels of tumor markers in patients with tumor metastasis were significantly higher than those in patients without tumor metastasis, with a statistically significant difference (p<0.001). The combination of four markers was better than single tumor marker in the evaluation indexes of diagnostic effect. The combined detection of multiple tumor markers and blood lipid indexes was correlated with the occurrence of five adverse reactions of chemotherapy (p<0.05).

CONCLUSION: The detection of multiple tumor markers and blood lipid indexes can effectively improve the diagnosis of colorectal cancer and enhance the predictive effect on adverse reactions of chemotherapy. HDL, LDL and ApoAI indexes can be used to diagnose the benign and malignant properties of tumors, and determine the clinical stages.

PMID:34564974

J BUON. 2021 Jul-Aug;26(4):1266-1270.

ABSTRACT

PURPOSE: Never before the preoperative quality of life (QoL) score of colorectal cancer (CRC) patients was analyzed and linked directly to cancer staging according to pathology in specimens and, thereafter, in patients to estimate long-term prognosis. Our study attempted to give answers to these questions.

METHODS: This was a prospective study of 80 elderly patients who underwent major colorectal surgery for cancer in a single University’s surgical department conducted between 01/2018 and 12/2018. All patients aged >65 years, diagnosed with a resectable CRC without metastatic disease undergoing an elective surgery were prospectively included. As exclusion criteria were considered age <65 years, an emergency operation, non-resectable tumor, stage IV CRC and American Society of Anesthesiologists (ASA) score IV. All patients were asked to answer a self-administered questionnaire of the validated Greek version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30.

RESULTS: Comparison of the mean score of EORTC QLQ-C30 showed stage I CRC was 87.62% (11.81%), 77.24% (12.91%) in stage II patients and 78.99% (15.25%) in stage III cancer. The mean difference between the three groups was statistically significant (p=0.002). Moreover, in post-hoc analysis, there was a statistically significant difference in the mean QLQ-C30 score between patients with stage I and stage II cancer (p=0.043) and between patients with stage I and stage III tumor (p=0.01), but this difference was not observed when comparing patients with stage II and III cancer (p=0.319).

CONCLUSION: Our study demonstrated a significant association between preoperative QoL and tumor staging as shown in the specimen’s examination in elderly patients with CRC. More prospective studies are needed to elucidate how QoL and its fluctuations during the postoperative period can be correlated with long-term survival and disease progression in elderly CRC patients.

PMID:34564980