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.

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.

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.