1.Prognostic factors for overall survival in patients with Merkel cell carcinoma
Rujing PAN ; Xuan XUAN ; Liyue HOU ; Jingjing LIU
Chinese Journal of Endocrine Surgery 2020;14(5):422-427
Objective:To identify prognosis factors in patients with resected Merkel cell carcinoma and construct a nomogram for predicting 3- and 5-year overall survival.Methods:A total of 1271 patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. According to the ratio of 70:30, patients were randomly divided into training cohort ( n=891) and validation cohort ( n=380) . Cox regression model was fitted with R software, thus the prognostic factors for 3- and 5-year overall survival were confirmed and a nomogram to predict overall survival was established. C-index was used to evaluate model discrimination and the calibration plot was used to evaluate model accuracy.The predictive power of the model was compared with the eighth TNM staging system. Results:Multivariable cox analysis indicated age, sex, tumor size, N stage, M stage, marital status and radiation therapy were associated with overall survival. The above predictors were employed to build a new nomogram, and we found that the new predictive model was better at predicting 3- and 5- year overall survival than the latest TNM staging system. The C-index of the training cohort using the new model for survival prediction was 0.72, and the C-index of the training cohort using TNM staging system was only 0.64. The C-index of the validation cohort using the new model for survival prediction was 0.73, while the C-index of the validation cohort using TNM staging system was 0.63. The nomogram also displayed a good calibration.Conclusions:The new predictive model with comprehensive prognostic factors is superior to the 8th TNM staging system in predicting overall survival of patients with Merkel cell carcinoma. This new model can help doctors to predict the prognosis of each patient more accurately, and assist clinical decision-making and individualized treatment.
2.Development and validation of a nomogram for predicting cancer-specific survival in pediatric melanoma
Rujing PAN ; Xuan XUAN ; Mingfen LYU ; Jingjing LIU
Chinese Journal of Endocrine Surgery 2021;15(6):572-577
Objective:To identify prognosis factors and construct a nomogram for the prediction of cancer-specific survival in surgically resected pediatric melanoma.Methods:A total of 912 patients aged 0-19 years were extracted from the Surveillance, Epidemiology, and SEER database and randomly divided into training cohort (n=640) and validation cohort (n=272) (A ratio of 70:30) . Univariable and multivariable cox analysis were used to determine prognostic factors, and these factors were used to construct a nomogram for predicting cancer-specific survival in patients with resected pediatric melanoma. Model performance was evaluated by Harrell’s concordance index (C-index) ,the area under the time-dependent receiver operating characteristic curve (AUC) and calibration plots.Results:As revealed by the multivariable cox analysis, age, tumor location, ulceration, and lymph node status were all associated with melanoma-specific survival in pediatric patients. On the basis of these factors, a nomogram was constructed. Both the training cohort and the validation cohort had a concordance index of 0.9, which validated the accuracy of our nomogram. The nomogram showed significant discriminative power in both training cohort (3-year AUC: 0.87, 5-year AUC: 0.88, 10-year AUC: 0.85) and validation cohort (3-year AUC: 0.87, 5-year AUC: 0.87, 10-year AUC: 0.89) . Also, the nomogram displayed a good calibration.Conclusions:These results suggest that the new model has superior predictive performance in predicting cancer-specific survival of pediatric melanoma. This individualized prediction model can provide reference for tailoring treatment and clinical counseling of pediatric melanoma.
3.Expression of Serum FABP4 and FGF19 Levels in Patients with β-Thalassemia and Their Relationship with Prognosis
Yixin CHEN ; Feng PAN ; Ya XU ; Xin PENG ; Lu LIANG ; Rujing LI ; Cong LI ; Hongxin ZENG
Journal of Modern Laboratory Medicine 2024;39(5):96-101
Objective To explore the expression of serum fatty acid-binding protein 4(FABP4)and fibroblast growth factor 19(FGF19)in patients with β-thalassemia and their relationship with clinical prognosis.Methods A total of 112 cases ofβ-thalassemia patients diagnosed and treated in Qianjiang Hospital Affiliated to Chongqing University from January 2018 to August 2020 were selected as the case group,and 60 healthy individuals who underwent physical examinations during the same period were taken as the control group.Enzyme-linked immunosorbent assay was used to detect levels of serum FABP4 and FGF19 expression.Multivariate logistic regression analysis was used to analyze factors affecting the prognosis of patients with β-thalassemia.Receiver operating characteristic curve was used to analyze the prognostic value of FABP4 and FGF19 in patients with β-thalassemia.Results The serum FABP4 level(67.13±11.35 μg/L)in the case group was higher than that in the control group(22.01±4.16μg/L),while the serum FGF19 level(104.24±21.46 ng/L)was lower than that in the control group(218.01±36.79 ng/L),with significant differences(t=29.708,25.620,all P<0.05).The serum FABP4 levels(54.20±12.63 μ g/L,66.83±10.5 μ g/L,79.72±11.05 μ g/L)in the mild group,intermediate group,and severe group were increased sequentially,while FGF19 levels(122.53±22.36 ng/L,103.16±20.37 ng/L,86.53±18.14 ng/L)were decreased sequentially,and the differences were significant(F=39.701,24.231,all P<0.05).Compared to the survival group,serum FGF19 level(62.80±22.09 ng/L vs 110.16±20.69 ng/L),Hb and the proportion of heterozygous genotypes in the death group patients(β CD17/β N,β CD41-42/β N)was lower,while serum FABP4(116.69±12.30 ng/L vs 60.05±10.17 ng/L),ferritin and the proportion of cardiac enlargement were higher,with significant differences(t/x2=4.436~18.981,all P<0.05).FGF19(OR=0.634,95%CI:0.451~0.891)was an independent protective factor for β-thalassemia patients(P<0.001),and serum FABP4(OR=1.840,95%CI:1.193~2.838)was an independent risk factor for prognosis(P<0.001).The area under the curve(95%CI)of serum FABP4 and FGF19 combination in prognosis evaluation for β-thalassemia patients was 0.897(0.853~0.951),which was greater than the single serum indicator detection of 0.842(0.801~0.879)and 0.814(0.762~0.858),with significant differences(Z=4.864,5.270,P=0.002,0.001).Conclusion The serum FABP4 expression is increased,but serum FGF19 expression is decreased in patients with β-thalassemia.The combination of serum FABP4 and FGF19 may have a high predictive value for the prognosis of patients with β-thalassemia.
4.Epidemiological characteristics of an epidemic of 2019-nCoV Omicron variant infection in Beijing
Yamin SUN ; Feng LIU ; Wei CAI ; Lina JIN ; Li GUO ; Run CAI ; Rujing SHI ; Fangyao LIU ; Chu JIANG ; Jiye FU ; Yang PAN ; Xiangfeng DOU ; Shuangsheng WU
Chinese Journal of Epidemiology 2022;43(12):1881-1886
Objective:To analyze the epidemiological characteristics and transmission chain of an epidemic of COVID-19 in Haidian district, Beijing.Methods:Descriptive epidemiological method was used to analyze the epidemiological characteristics of the epidemic, and field investigation and big data technology were used to analyze the transmission chain of the epidemic.Results:From April 27 to May 13, 2022, an epidemic of COVID-19 occurred in Haidian district. The strains isolated from the cases were identified by whole genome sequencing as Omicron variant (BA.2.2 evolutionary branch). A total of 38 infection cases were detected, including 34 confirmed cases and 4 asymptomatic cases. Most cases were mild ones (88.2%), no severe, critical or death cases occurred. The early clinical symptoms were mainly sore throat (50.0%) and cough (29.4%). The epidemic lasted for 17 days, resulting in 7 generations of the cases and involving 3 community transmissions, 2 working place transmissions and 8 family transmissions; the main infection routes were co-residence (47.6%) and co-space exposure (31.6%). The intergenerational interval M( Q1, Q3)was 3 (1, 6) days. The overall secondary attack rate was 1.5% (37/2 482), and the family secondary attack rate was 36.7% (18/49). Conclusions:The cases in this COVID-19 epidemic caused by Omicron variant had mild clinical symptoms, but the case clustering in families and communities was obvious, the transmission was rapid, and the risk for co-space exposure was high. It is necessary to use information technology to identify close contacts in the local population for the rapid and effective blocking of the epidemic spread.
5.Epidemiological study of high risk human papillomavirus infection in 25 to 54 years old married women in Beijing
Minghui WU ; Songwen ZHANG ; Weiyuan ZHANG ; Baoli ZHOU ; Zheng XIE ; Jiandong WANG ; Jing FENG ; Junhua WANG ; Jiwei JIANG ; Li ZHU ; Shiquan HUANG ; Jing PAN ; Xinzhi LIU ; Yunping ZHANG ; Wen ZHAO ; Hong LI ; Xiaohang LUO ; Kunchong SHI ; Guifeng WANG ; Liping FU ; Guixiang LI ; Hunfen TAO ; Chunxiang BAI ; Ruixia HE ; Lei JIN ; Guangmei LIU ; Kuixiang WANG ; Jialin YE ; Siying LIU ; Mei WANG ; Xueming YAN ; Guiling HU ; Rujing LIN ; Changyue SUN ; Hong ZENG ; Lirong WU ; Yali CHENG
Chinese Journal of Obstetrics and Gynecology 2009;44(12):892-897
Objective To investigate high risk human papillomavirus(HR-HPV)prevalence among married women in Beijing and to study the high risk flactors.nethods During March 2007 to September 2008.a total of 6185 married women sampled from 137 communities in 12 districts were screened bv HR-HPV DNA test and cytogical test.The interview was carried out with unified questionnaires.The databage was set up and twice entered in EpiDam 3.0.After checked up,the data were analyzed in SPSS 15.0.Results (1) The HR-HPV infection rate was 9.89%.The HR-HPV infection rate of the city zone,the suburb and the exurb were 9.34%,10.51% and 9.51% (P>0.05).The HR-HPV infection rate of the native and the oudander were 9.53%,11.30% (P<0.05).(2) The age distribution of HR-HPV infection was that the rate was around 10% among 25 to 44 age groups,which was the highest(11.21%) in 30 to 34 age group;then the rate was descended as the age raising,the rate of 50 to 54 age group was the lowest(7.78%).(3) Multiple logistic regression showed that the related risk factors of HR-HPV infection mainly included 1000 RMB and above of family income per person per month.possessing more than 1 sexual partner of her husband,outlander and hish levels of education.(4) The prevalence of cervical intraepithelial neoplasia(CIN)in HR-HPV positive group wag significantly higher than that in HR-HPV negative group(29.76% vs 3.32%,P<0.01).Conclusions(1)The HR-HPV infection rate among aged 25 to 54 years was 9.9% and there was no significant difference in area distribution.(2)The hish risk population which should strengthen screening was the married bearing-age women with high level of family income,outlander,high levels of education and her husband possessing more than 1 sexual partner.(3)HR-HPV infection is the main risk factor for CIN and cervical cancer.while does not provide a causal relationship with them.The high risk population should be checked regularly to understand the development of HR-HPV infection and CIN incidence.