1.Relationship between HER2 and Ki-67 expression in colorectal cancer and prognostic factors analysis
Xuling SUN ; Jing SHEN ; Guilin HUANG ; Yujiang LI ; Zhigang LI
Chongqing Medicine 2018;47(12):1610-1615
Objective To investigate the role of HER2 and Ki-67 in colorectal cancer pathogenesis and their influence on the prognosis in the patients with colorectal cancer.Methods The expressions of HER2 and Ki-67 proteins in colorectal cancer tissues from 71 cases of colorectal cancer and 30 cases of para-cancerous normal tissues were detected by usingthe immunohistochemistry.The expressions of HER2,Ki-67 and their clinicopafhological parameters and prognostic significance were also analyzed.Results The positive expression rate of HER2 in colorectal cancer tissue (32.4%) was higher than that in para-cancerous normal tissues (10.0%);the positive expression rate ofKi-67 in colorectal cancer tissue (85.9%) was significantly higher than that in para-cancerous normal tissues (6.7 %),the difference was statistically significant (P<0.05).The expression of HER2 in colorectal cancer tissues was correlated with tumor differentiation degree,lymph node metastasis,number of lymph node metastasis and TNM staging (P<0.05).The expression of Ki-67 in colorectal cancer tissues was correlated with infiltration depth,lymph node metastasis,number of lymph node metastasis and TNM staging (P<0.05).HER2 in colorectal cancer tissues was positively correlated with Ki-67 (r=0.515,P=0.001).The 5-year disease-free survival rates in the HER2 positive group and the HER2 negative group were 48.4% and 80.8%,the difference was statistically significant (P<0.05).The 5-year diseasefree survival rates in the Ki-67 high expression group and the Ki-67 low expression group were 56.5 % and 85.5%,the difference was statistically significant (P<0.05).The 5-year survival rate in the HER2 positive group and the HER2 negative group were 60.9 % and 85.5 %,the difference was statistically significant (P<0.05).The 5-year survival rate in the Ki-67 high expression group and the Ki-67 low expression group were 63.9% and 85.5 %,the difference was statistically significant (P<0.05).The single factor analysis showed that tumor differentiation degree,infiltration depth,lymph node metastasis,number of lymph node metastasis,TNM staging,the expressions of HER2 and Ki-67 were related with prognosis in the patients with colorectal cancer (P<0.05).The Cox multivariate analysis results showed that tumor infiltration depth and TMN staging were the independent factors affecting prognosis in the patients with colorectal cancer.Conclusion The expressions of HER2 and Ki-67 are associated with the development of colorectal cancer.The 5-year disease-free survival rate and the 5-year survival rate in the patients with HER2 and Ki-67 positive become significantly decreased.
2.The best evidence for the management of ovarian hyper-stimulation syndrome in patients undergoing assisted reproductive therapy
Yu HE ; Zilian WANG ; Yongmei ZHANG ; Xuechun JIANG ; Xuling SHEN ; Meiling XU ; Qun WEI
Journal of Zhejiang University. Medical sciences 2024;53(5):632-640
Objective:To summarize the best evidence for the management of ovarian hyperstimulation syndrome in patients undergoing assisted reproductive therapy.Methods:Evidence related to the management of ovarian hyperstimulation syndrome in patients undergoing assisted reproductive therapy,including guidelines,clinical decision,best clinical practice,systematic evaluation,expert consensus and evidence summary and related original research were systematically searched in UpToDate,BMJ Best Practice,World Health Organization(WHO)website,Guidelines International Network(GIN),National Institute for Health and Clinical Excellence(NICE)website,National Guidelines website,American Society for Reproductive Medicine(ASRM)website,New York Academy of Sciences(NYAS)website,Joanna Briggs Institute(JBI)database,Cochrane Library,CINAHL,PubMed,Wanfang database,CNKI,and China Biomedical Literature Database from inception to May 31,2024.Two researchers independently evaluated the quality of the literature,and a senior researcher made the final decision for literature inclusion.Results:A total of 15 articles were included in the study.Following quality assessment,one article was excluded.The remaining 14 articles included 5 practice guidelines,3 systematic reviews,2 expert consensuses,1 evidence summary,and 3 from UpToDate.Ultimately,27 pieces of evidence were identified across five key aspects:risk assessment,disease monitoring,early prevention,institutional management and health education.Conclusion:The updated evidence indicates that the monitoring and prevention of ovarian hyperstimulation syndrome should start early,personalized treatment plans should be provided for patients,and the rational allocation of treatment resources needs to be promoted to enhance effective management of ovarian hyper-stimulation syndrome.