1.Survival Analysis of 478 Hospitalized Patients with Prostate Cancer
Jun XU ; Haizhen CHEN ; Lingling LU ; Bo CAI ; Hong XU ; Yuexia GAO ; Jianguo CHEN
China Cancer 2025;34(6):477-483
[Purpose]To analyze the survival rate of prostate cancer patients hospitalized in Nan-tong Tumor Hospital from 2007 to 2017.[Methods]A total of 478 prostate cancer patients were admitted in Nantong Tumor Hospital from 2007 to 2017 and 476 cases(99.58%)were followed up till December 31,2020.The survival rate of patients was analyzed with Kaplan-Meier method;Soft-ware SPSS 25.0 and the Log-rank test were employed for statistical analysis.[Results]The aver-age age of prostate cancer patients at admission was(71.74±8.02)years old,and 79.08%were aged 60~79 years.The median survival time was 43 months,and the observed 1-,3-,5-and 10-year survival rates were 77.20%,56.07%,43.01%and 24.53%,respectively.The 5-year survival rates for the age groups of 35~59,60~79 and ≥80 years old were 31.73%,46.64%and 29.65%,respectively(P<0.05).The 5-year survival rates for patients with stage Ⅰ~Ⅱ,stage Ⅲ,stage IV,and unknown stage were 88.10%,71.66%,33.35%and 37.55%,respectively(P<0.001).The 5-year survival rates for the periods 2007-2012 and 2013-2017 were 32.85%and 47.79%,re-spectively(P<0.05).Furthermore survival rates differed significantly across different regions within the jurisdiction(P<0.05).[Conclusion]Over the past decade,the survival rate of hospital-based prostate cancer patients has significantly improved.Early-stage cases can achieve better survival rates,but the survival rate of elderly patients remains a challenge.Efforts should be made to reduce the proportion of patients with unknown staging Comprehensive measures for prostate cancer prevention and control should be strengthened to reduce incidence,improve prognosis and enhance quality of life of patients.
2.Application value of an aMAP score in predicting the occurrence of hepatocellular carcinoma in patients with chronic hepatitis B receiving antiviral therapy
Yifan GAO ; Zhenzhong LIU ; Luyuan MA ; Yuexia LIU ; Caiyan ZHAO
Chinese Journal of Hepatology 2025;33(4):359-365
Objective:To evaluate the predictive value of an aMAP score for the occurrence risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving antiviral therapy.Methods:The medical records of 508 CHB patients who started receiving antiviral treatment in the Third Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang from January 2001 to November 2021 were retrospectively analyzed. They were divided into low-, intermediate-, and high-risk groups according to the aMAP, AASL-HCC, PAGE-B, mPAGE-B, and CAMD scoring criteria. At the end of follow-up, they were divided into HCC (33 cases) and non-HCC group (475 cases) according to whether HCC occurred. The occurrence risk factors for HCC were analyzed by univariate and multivariate Cox regression analysis. The cumulative incidence of HCC at different time points was estimated by the Kaplan-Meier method and compared by the log-rank method. The HCC prediction performance of the aMAP score was evaluated by the receiver operating characteristic (ROC) curve and compared with other scores. The Mann-Whitney U test, or Fisher test, was used to compare the non-normally distributed quantitative data between groups. The χ2 test was used to compare the count data between groups. Results:A total of 33 cases (6.5%) developed HCC during the median follow-up period of 8.7 (6.8-8.9) years. Multivariate analysis showed that age>50 years ( HR=2.804, 95% CI 1.332-5.902; P=0.007) and liver cirrhosis ( HR=11.808, 95% CI 4.360-31.976; P<0.001) were independent risk factors for HCC occurrence. The cumulative incidence of HCC defined by the aMAP score at 3 and 5 years was significantly lower in the low-risk group (0, 0) than that in the intermediate-risk group (4.4%, 5.4%) and the high-risk group (10.8%, 18.5%), P<0.001. The aMAP score performed similarly to the AASL-HCC score, mPAGE-B score, and CAMD score [area under the ROC curve (AUC) was 0.863, 0.900, 0.851, and 0.886, respectively], with P>0.05 in terms of the 3-year HCC prediction performance; and was equally superior with the PAGE-B score (AUC was 0.732), with P<0.05. The aMAP score was not worse than the AASL-HCC score and CAMD score (AUC was 0.890, 0.894, and 0.882, respectively), with P>0.05 in terms of the 5-year HCC prediction performance; however, it was significantly superior to the PAGE-B score and mPAGE-B score (AUC was 0.795 and 0.875, respectively), with P<0.05. In addition, the AUC of the aMAP score for predicting HCC occurrence at baseline, 1 year, 2 years, and 3 years of antiviral treatment was>0.9. Conclusions:The aMAP score can accurately assess the risk of HCC in CHB patients receiving antiviral therapy.
3.Evaluation of the short-term prognosis of patients with HBV-related acute-on-chronic liver failure by combining ferritin with COSSH-ACLF II score
Yuexia LIU ; Ziyue LI ; Luyuan MA ; Yifan GAO ; Ya WANG ; Caiyan ZHAO
Chinese Journal of Hepatology 2025;33(5):456-462
Objective:To explore the predictive value of ferritin combined with the COSSH-ACLF Ⅱ score for the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF).Methods:The clinical data of 419 cases with HBV-ACLF hospitalized at the Third Hospital of Hebei Medical University were retrospectively analyzed between January 1, 2013 and September 30, 2022, and were divided into the death ( n=127) and survival group ( n=292) according to the survival status of 28 days of follow-up. The Mann-Whitney U test was used to compare confirmation of non-normally distributed continuous data between two groups. The chi-square test was used for the comparison of numerical data between the two groups. Binary logistic regression analysis was used to analyze the independent risk factors affecting the prognosis of HBV-ACLF patients. The predictive value of ferritin combined with the COSSH-ACLF Ⅱ score on the prognosis of HBV-ACLF was evaluated by the receiver operating characteristic curve (ROC curve) and area under the curve (AUC), net reclassification index (NRI), and comprehensive discriminant improvement index (IDI). Results:There were statistically significant differences in age, neutrophil count (NEUT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), serum creatinine (Scr), serum urea, prothrombin time (PT), prothrombin activity (PTA), international normalized ratio (INR), serum ferritin (SF), hepatic encephalopathy, and COSSH-ACLF Ⅱ scores between the two groups ( P<0.05). Ferritin ( OR=1.001, 95% CI:1.001-1.002, P<0.001) and COSSH-ACLF Ⅱ score ( OR=2.898, 95% CI:1.560-5.384, P<0.001) were independent factors for predicting short-term prognosis for patients with HBV-ACLF. Ferritin combined with COSSH-ACLF II score had a higher prognostic predictive value than ferritin (AUC=0.697, 95% CI: 0.651-0.741) and COSSH-ACLF II score (AUC=0.819, 95% CI: 0.779-0.855) for patients with HBV-ACLF (AUC=0.857, 95% CI: 0.819-0.889), with a statistically significant difference ( Z=6.287 and 2.666, respectively, P <0.05). The predictive effect was significantly improved following the addition of ferritin to the COSSH-ACLF Ⅱ score ( P<0.001), and the NRI and IDI were both >0 (NRI=0.144, 95% CI: 0.064-0.225; IDI=0.080, 95% CI: 0.052-0.108). Conclusion:Ferritin and COSSH-ACLF Ⅱ scores are independent factors that can predict short-term prognosis for patients with HBV-ACLF, and combing both has a higher predictive value.
4.Incidence trend and age-period-cohort analysis of lung cancer in Qidong from 1972 to 2021
Jun XU ; Yongsheng CHEN ; Jun WANG ; Jian ZHU ; Yuexia GAO
Chinese Journal of Oncology 2025;47(11):1066-1073
Objective:To describe the epidemiological characteristics and trends of lung cancer incidence in Qidong City, Jiangsu Province, China, between 1972 and 2021, and provide guidelines for prevention and control.Methods:Data on lung cancer with onset from January 1, 1972 to December 31, 2021 and coded as C33-C34 in the International Classification of Diseases (10th edition) were extracted from the tumor registry database of Qidong City. Population data of Qidong City for each year from 1972 to 2021 were extracted from the annual report of household registration of the Public Security Bureau of Qidong City. The crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), 35-64 years truncated rate, 0-74 years cumulative rate, and cumulative risk were calculated. Average annual percentage change (AAPC) was calculated by Joinpoint software for CR, ASRC, and ASRW. The age-period-cohort (APC) model was used to analyze the influence of age, period, and birth cohort on the changes in the incidence trend of lung cancer.Results:From 1972 to 2021, there were 26 996 patients of lung cancer in Qidong, accounting for 18.30% (26 996/147 519) of all cancer new cases. The CR of lung cancer was 48.13/10 5, the ASRC was 29.65/10 5, and the ASRW was 29.67/10 5. The truncated incidence of 35-64 years old was 42.64/10 5, the cumulative incidence rate between the ages between 0-74 years old was 3.71%, and the cumulative risk was 3.64%. There were 18 572 male patients, with the CR, ASRC, and ASRW being 67.15/10 5, 43.82/10 5, and 43.87/10 5, respectively. The number of female patients was 8 424, and the CR, ASRC, and the ASRW were 29.62/10 5, 17.63/10 5, and 17.55/10 5, respectively. Temporal analysis indicated significant upward trends in the ASRCs for both genders combined, males, and females, with AAPC values of 2.21%, 1.76%, and 2.98% (all P<0.001), respectively. Age-specific incidence rates increased with age, peaking at 275.34/10 5 in the 75+ years age group, with an increasing trend in all age groups and the greatest increase in the 75+ years age group, with an AAPC value of 3.53% ( P<0.001). The results of the APC model showed that the net drift value of lung cancer incidence was 2.06% (95% CI: 1.72%-2.41%), and the highest value of local drift was 3.93% (95% CI: 3.20%-4.68%) in the 80+ years old group. The risk of cancer increases with age in the age effect. The period effect of the incidence rate ratio (RR) value increased from 1.12 during 1997-2001 to 2.09 during 2017-2021. The cohort effect of the RR value for risk of incidence increased from 0.17 during 1892-1896 to 2.54 during 1987-1991. Conclusions:From 1972 to 2021, the incidence rate of lung cancer in Qidong City showed an upward trend. Age, period, and cohort are all major factors influencing the incidence of lung cancer. It is necessary to develop precise and comprehensive prevention and control strategies to curb this increasing trend of lung cancer incidence.
5.Practice of " 6 New" inpatient multidisciplinary diagnosis and treatment of a tertiary hospital
Jiawei GU ; Jingwei ZHANG ; Haijun HUANG ; Yucheng ZHOU ; Zhiqiang WU ; Yuexia WU ; Yang GAO
Chinese Journal of Hospital Administration 2025;41(3):186-190
The multidisciplinary diagnosis and treatment (MDT) mode plays a positive role in diagnosing and treating difficult and complicated diseases, improving service quality, and promoting the construction of an integrated medical system. In March 2023, Zhejiang Provincial People′s Hospital had launched the " 6 New" MDT management practice to further improve the hospital′s inpatient MDT service level, including new concepts, new architectures, new standards, new processes, new models, and new quality control. This practice had improved the quality and efficiency of MDT management and promoted interdisciplinary integration by strengthening top-level design, establishing MDT leadership and quality control teams, developing relevant standards and specifications, enhancing the level of information management throughout the entire process, implementing diversified MDT models, and implementing quality control measures. As of July 2024, the hospital had established 80 MDT teams covering 30 clinical departments, conduct 120 MDT discussions for hospitalized cases per month, and with the continuous promotion of inpatient MDT work, the number of MDT teams and cases continued to increase. This practice had achieved good results and could provide references for other public hospitals in China to improve the level of inpatient MDT services.
6.Incidence trend and age-period-cohort analysis of lung cancer in Qidong from 1972 to 2021
Jun XU ; Yongsheng CHEN ; Jun WANG ; Jian ZHU ; Yuexia GAO
Chinese Journal of Oncology 2025;47(11):1066-1073
Objective:To describe the epidemiological characteristics and trends of lung cancer incidence in Qidong City, Jiangsu Province, China, between 1972 and 2021, and provide guidelines for prevention and control.Methods:Data on lung cancer with onset from January 1, 1972 to December 31, 2021 and coded as C33-C34 in the International Classification of Diseases (10th edition) were extracted from the tumor registry database of Qidong City. Population data of Qidong City for each year from 1972 to 2021 were extracted from the annual report of household registration of the Public Security Bureau of Qidong City. The crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), 35-64 years truncated rate, 0-74 years cumulative rate, and cumulative risk were calculated. Average annual percentage change (AAPC) was calculated by Joinpoint software for CR, ASRC, and ASRW. The age-period-cohort (APC) model was used to analyze the influence of age, period, and birth cohort on the changes in the incidence trend of lung cancer.Results:From 1972 to 2021, there were 26 996 patients of lung cancer in Qidong, accounting for 18.30% (26 996/147 519) of all cancer new cases. The CR of lung cancer was 48.13/10 5, the ASRC was 29.65/10 5, and the ASRW was 29.67/10 5. The truncated incidence of 35-64 years old was 42.64/10 5, the cumulative incidence rate between the ages between 0-74 years old was 3.71%, and the cumulative risk was 3.64%. There were 18 572 male patients, with the CR, ASRC, and ASRW being 67.15/10 5, 43.82/10 5, and 43.87/10 5, respectively. The number of female patients was 8 424, and the CR, ASRC, and the ASRW were 29.62/10 5, 17.63/10 5, and 17.55/10 5, respectively. Temporal analysis indicated significant upward trends in the ASRCs for both genders combined, males, and females, with AAPC values of 2.21%, 1.76%, and 2.98% (all P<0.001), respectively. Age-specific incidence rates increased with age, peaking at 275.34/10 5 in the 75+ years age group, with an increasing trend in all age groups and the greatest increase in the 75+ years age group, with an AAPC value of 3.53% ( P<0.001). The results of the APC model showed that the net drift value of lung cancer incidence was 2.06% (95% CI: 1.72%-2.41%), and the highest value of local drift was 3.93% (95% CI: 3.20%-4.68%) in the 80+ years old group. The risk of cancer increases with age in the age effect. The period effect of the incidence rate ratio (RR) value increased from 1.12 during 1997-2001 to 2.09 during 2017-2021. The cohort effect of the RR value for risk of incidence increased from 0.17 during 1892-1896 to 2.54 during 1987-1991. Conclusions:From 1972 to 2021, the incidence rate of lung cancer in Qidong City showed an upward trend. Age, period, and cohort are all major factors influencing the incidence of lung cancer. It is necessary to develop precise and comprehensive prevention and control strategies to curb this increasing trend of lung cancer incidence.
7.Survival Analysis of 478 Hospitalized Patients with Prostate Cancer
Jun XU ; Haizhen CHEN ; Lingling LU ; Bo CAI ; Hong XU ; Yuexia GAO ; Jianguo CHEN
China Cancer 2025;34(6):477-483
[Purpose]To analyze the survival rate of prostate cancer patients hospitalized in Nan-tong Tumor Hospital from 2007 to 2017.[Methods]A total of 478 prostate cancer patients were admitted in Nantong Tumor Hospital from 2007 to 2017 and 476 cases(99.58%)were followed up till December 31,2020.The survival rate of patients was analyzed with Kaplan-Meier method;Soft-ware SPSS 25.0 and the Log-rank test were employed for statistical analysis.[Results]The aver-age age of prostate cancer patients at admission was(71.74±8.02)years old,and 79.08%were aged 60~79 years.The median survival time was 43 months,and the observed 1-,3-,5-and 10-year survival rates were 77.20%,56.07%,43.01%and 24.53%,respectively.The 5-year survival rates for the age groups of 35~59,60~79 and ≥80 years old were 31.73%,46.64%and 29.65%,respectively(P<0.05).The 5-year survival rates for patients with stage Ⅰ~Ⅱ,stage Ⅲ,stage IV,and unknown stage were 88.10%,71.66%,33.35%and 37.55%,respectively(P<0.001).The 5-year survival rates for the periods 2007-2012 and 2013-2017 were 32.85%and 47.79%,re-spectively(P<0.05).Furthermore survival rates differed significantly across different regions within the jurisdiction(P<0.05).[Conclusion]Over the past decade,the survival rate of hospital-based prostate cancer patients has significantly improved.Early-stage cases can achieve better survival rates,but the survival rate of elderly patients remains a challenge.Efforts should be made to reduce the proportion of patients with unknown staging Comprehensive measures for prostate cancer prevention and control should be strengthened to reduce incidence,improve prognosis and enhance quality of life of patients.
8.Practice of " 6 New" inpatient multidisciplinary diagnosis and treatment of a tertiary hospital
Jiawei GU ; Jingwei ZHANG ; Haijun HUANG ; Yucheng ZHOU ; Zhiqiang WU ; Yuexia WU ; Yang GAO
Chinese Journal of Hospital Administration 2025;41(3):186-190
The multidisciplinary diagnosis and treatment (MDT) mode plays a positive role in diagnosing and treating difficult and complicated diseases, improving service quality, and promoting the construction of an integrated medical system. In March 2023, Zhejiang Provincial People′s Hospital had launched the " 6 New" MDT management practice to further improve the hospital′s inpatient MDT service level, including new concepts, new architectures, new standards, new processes, new models, and new quality control. This practice had improved the quality and efficiency of MDT management and promoted interdisciplinary integration by strengthening top-level design, establishing MDT leadership and quality control teams, developing relevant standards and specifications, enhancing the level of information management throughout the entire process, implementing diversified MDT models, and implementing quality control measures. As of July 2024, the hospital had established 80 MDT teams covering 30 clinical departments, conduct 120 MDT discussions for hospitalized cases per month, and with the continuous promotion of inpatient MDT work, the number of MDT teams and cases continued to increase. This practice had achieved good results and could provide references for other public hospitals in China to improve the level of inpatient MDT services.
9.Application value of an aMAP score in predicting the occurrence of hepatocellular carcinoma in patients with chronic hepatitis B receiving antiviral therapy
Yifan GAO ; Zhenzhong LIU ; Luyuan MA ; Yuexia LIU ; Caiyan ZHAO
Chinese Journal of Hepatology 2025;33(4):359-365
Objective:To evaluate the predictive value of an aMAP score for the occurrence risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving antiviral therapy.Methods:The medical records of 508 CHB patients who started receiving antiviral treatment in the Third Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang from January 2001 to November 2021 were retrospectively analyzed. They were divided into low-, intermediate-, and high-risk groups according to the aMAP, AASL-HCC, PAGE-B, mPAGE-B, and CAMD scoring criteria. At the end of follow-up, they were divided into HCC (33 cases) and non-HCC group (475 cases) according to whether HCC occurred. The occurrence risk factors for HCC were analyzed by univariate and multivariate Cox regression analysis. The cumulative incidence of HCC at different time points was estimated by the Kaplan-Meier method and compared by the log-rank method. The HCC prediction performance of the aMAP score was evaluated by the receiver operating characteristic (ROC) curve and compared with other scores. The Mann-Whitney U test, or Fisher test, was used to compare the non-normally distributed quantitative data between groups. The χ2 test was used to compare the count data between groups. Results:A total of 33 cases (6.5%) developed HCC during the median follow-up period of 8.7 (6.8-8.9) years. Multivariate analysis showed that age>50 years ( HR=2.804, 95% CI 1.332-5.902; P=0.007) and liver cirrhosis ( HR=11.808, 95% CI 4.360-31.976; P<0.001) were independent risk factors for HCC occurrence. The cumulative incidence of HCC defined by the aMAP score at 3 and 5 years was significantly lower in the low-risk group (0, 0) than that in the intermediate-risk group (4.4%, 5.4%) and the high-risk group (10.8%, 18.5%), P<0.001. The aMAP score performed similarly to the AASL-HCC score, mPAGE-B score, and CAMD score [area under the ROC curve (AUC) was 0.863, 0.900, 0.851, and 0.886, respectively], with P>0.05 in terms of the 3-year HCC prediction performance; and was equally superior with the PAGE-B score (AUC was 0.732), with P<0.05. The aMAP score was not worse than the AASL-HCC score and CAMD score (AUC was 0.890, 0.894, and 0.882, respectively), with P>0.05 in terms of the 5-year HCC prediction performance; however, it was significantly superior to the PAGE-B score and mPAGE-B score (AUC was 0.795 and 0.875, respectively), with P<0.05. In addition, the AUC of the aMAP score for predicting HCC occurrence at baseline, 1 year, 2 years, and 3 years of antiviral treatment was>0.9. Conclusions:The aMAP score can accurately assess the risk of HCC in CHB patients receiving antiviral therapy.
10.Evaluation of the short-term prognosis of patients with HBV-related acute-on-chronic liver failure by combining ferritin with COSSH-ACLF II score
Yuexia LIU ; Ziyue LI ; Luyuan MA ; Yifan GAO ; Ya WANG ; Caiyan ZHAO
Chinese Journal of Hepatology 2025;33(5):456-462
Objective:To explore the predictive value of ferritin combined with the COSSH-ACLF Ⅱ score for the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF).Methods:The clinical data of 419 cases with HBV-ACLF hospitalized at the Third Hospital of Hebei Medical University were retrospectively analyzed between January 1, 2013 and September 30, 2022, and were divided into the death ( n=127) and survival group ( n=292) according to the survival status of 28 days of follow-up. The Mann-Whitney U test was used to compare confirmation of non-normally distributed continuous data between two groups. The chi-square test was used for the comparison of numerical data between the two groups. Binary logistic regression analysis was used to analyze the independent risk factors affecting the prognosis of HBV-ACLF patients. The predictive value of ferritin combined with the COSSH-ACLF Ⅱ score on the prognosis of HBV-ACLF was evaluated by the receiver operating characteristic curve (ROC curve) and area under the curve (AUC), net reclassification index (NRI), and comprehensive discriminant improvement index (IDI). Results:There were statistically significant differences in age, neutrophil count (NEUT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), serum creatinine (Scr), serum urea, prothrombin time (PT), prothrombin activity (PTA), international normalized ratio (INR), serum ferritin (SF), hepatic encephalopathy, and COSSH-ACLF Ⅱ scores between the two groups ( P<0.05). Ferritin ( OR=1.001, 95% CI:1.001-1.002, P<0.001) and COSSH-ACLF Ⅱ score ( OR=2.898, 95% CI:1.560-5.384, P<0.001) were independent factors for predicting short-term prognosis for patients with HBV-ACLF. Ferritin combined with COSSH-ACLF II score had a higher prognostic predictive value than ferritin (AUC=0.697, 95% CI: 0.651-0.741) and COSSH-ACLF II score (AUC=0.819, 95% CI: 0.779-0.855) for patients with HBV-ACLF (AUC=0.857, 95% CI: 0.819-0.889), with a statistically significant difference ( Z=6.287 and 2.666, respectively, P <0.05). The predictive effect was significantly improved following the addition of ferritin to the COSSH-ACLF Ⅱ score ( P<0.001), and the NRI and IDI were both >0 (NRI=0.144, 95% CI: 0.064-0.225; IDI=0.080, 95% CI: 0.052-0.108). Conclusion:Ferritin and COSSH-ACLF Ⅱ scores are independent factors that can predict short-term prognosis for patients with HBV-ACLF, and combing both has a higher predictive value.

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