1.Analysis of influencing factors and construction of a risk prediction model for early death in adult glioma
Yujuan DAI ; Xianying CHEN ; Wei HUANG ; Dachao CHEN
Journal of International Oncology 2025;52(10):609-613
Objective:To explore the influencing factors of early death (within 3 months) in adult glioma patients, and to construct a risk prediction model.Methods:Retrospective analysis was performed on the clinical data of 228 adult glioma patients admitted to the 909th Hospital (Dongnan Hospital of Xiamen University) from June 2020 to June 2024. Patients were divided into a death group ( n=32) and a survival group ( n=196) based on whether death occurred within 3 months, and the clinical data between the two groups were compared. Multivariate logistic regression was used to analyze the influencing factors of death within 3 months, a logistic regression prediction model was constructed, and receiver operator characteristic (ROC) curve was plotted to analyze the predictive value of the model. Results:There were no statistically significant differences between the two groups in age, gender, hypertension, diabetes, tumor location, tumor involvement, neurological impairment, maximum tumor diameter, chemotherapy, or radiotherapy (all P>0.05). The death group showed higher proportions of cerebral herniation ( χ2=20.74, P<0.001), hospital admission Karnofsky performance status (KPS) score ≤70 ( χ2=26.66, P<0.001), tumor grade Ⅲ-Ⅳ ( χ2=28.70, P<0.001), MGMT promoter unmethylation ( χ2=10.25, P=0.001), IDH wild-type ( χ2=6.18, P=0.013), and incomplete tumor resection ( χ2=10.37, P=0.001) compared with the survival group. Multivariate analysis revealed that cerebral herniation ( OR=19.78, 95% CI: 5.33-73.41, P<0.001), hospital admission KPS score ≤70 ( OR=19.64, 95% CI: 5.54-69.59, P<0.001), tumor grade Ⅲ-Ⅳ ( OR=9.40, 95% CI: 3.02-29.27, P<0.001), MGMT promoter unmethylation ( OR=4.28, 95% CI: 1.18-15.54, P=0.027), and incomplete tumor resection ( OR=9.50, 95% CI: 2.72-33.23, P<0.001) were independent risk factors for early death in glioma patients. The risk prediction model for early death in glioma patients constructed based on these indicators was logit ( P) =-18.04+2.96×cerebral herniation (with=1, without=0) +2.98×hospital admission KPS score (≤70=1, >70=0) +2.24×tumor grade (Ⅲ-Ⅳ=1, Ⅰ-Ⅱ=0) +1.45×MGMT promoter methylation (no=1, yes=0) +2.25×complete tumor resection (no=1, yes=0). ROC curve analysis demonstrated that this model had predictive value for early death in glioma patients, with an area under the curve of 0.920 (95% CI: 0.868-0.972), a sensitivity of 0.842, and a specificity of 0.906. Conclusions:Cerebral herniation, hospital admission KPS score ≤70, tumor grade Ⅲ-Ⅳ, MGMT promoter unmethylation, and incomplete tumor resection are independent risk factors for early death in adult glioma patients. The risk prediction model constructed based on these indicators has good predictive value.
2.Value of tumor volume to uterine volume ratio combined with serum AFP, CA199, HE4 expression in evaluating pathological grade and prognosis of endometrial carcinoma
Chengxiang HUANG ; Cui LI ; Haitang ZHANG ; Yujuan LI ; Yanfen DAI ; Hongyun LIU
Chinese Journal of Endocrine Surgery 2025;19(4):589-594
Objective:To investigate the value of tumor volume to uterine volume ratio (N/U) combined with the expression of alpha-fetoprotein (AFP), sugar antigen 199 (CA199) and human epididymal secretory protein 4 (HE4) in evaluating the pathologic grade and prognosis of endometrial carcinoma (EC) .Methods:A total of 160 EC patients admitted to Linyi Central Hospital from Jan. 2021 to Dec. 2023 were divided into low-grade group and high-grade group according to FIGO grading method, and were divided into poor prognosis group and good prognosis group according to cancer death, recrudescence. The levels of N/U, AFP, CA199 and HE4 in patients with different pathologic grades and prognosis were compared. COX regression was used to analyze the influencing factors of EC adverse prognosis, ROC curve was used to analyze the value of N/U combined with serum AFP, CA199 and HE4 in predicting EC adverse prognosis, and a nomogram model was constructed.Results:Pathological examination of 160 EC patients showed that 12 cases were non-endometrioid adenocarcinoma, 148 cases were endometrioid adenocarcinoma, 41 cases were high-grade and 119 cases were low-grade.According to the follow-up, 94 of the 160 EC patients had good prognosis and 66 had poor prognosis. The levels of N/U, AFP, CA199 and HE4 in the poor prognosis group were higher than those in the good prognosis group ( P<0.05). COX regression analysis showed that high levels of N/U, AFP, CA199 and HE4 were all factors affecting the poor prognosis of EC patients ( P<0.05). The AUC value of combined detection of N/U, AFP, CA199 and HE4 in predicting adverse prognosis of EC patients was higher than that of single detection ( Z=3.140, 3.658, 4.277, 4.378, P<0.05) .The ROC curve AUC (95% CI) of the training set and the validation set were 0.84 (0.77-0.92) and 0.90 (0.81-0.98) respectively for the training set and the validation set to predict the adverse prognosis of EC patients. Calibration curve results showed that the calibration curve for EC patients predicted by the nomogram model was close to the ideal curve ( P=0.521, 0.743). The DCA curve shows that the probability threshold of the nomogram model has a higher positive net return at 20%~100%. Conclusion:The levels of N/U, AFP, CA199 and HE4 in EC patients are related to the pathologic grade, and the combined detection of these indicators can predict the poor prognosis of EC patients, and the nomogram model constructed based on these indicators has high predictive value.
3.Value of tumor volume to uterine volume ratio combined with serum AFP, CA199, HE4 expression in evaluating pathological grade and prognosis of endometrial carcinoma
Chengxiang HUANG ; Cui LI ; Haitang ZHANG ; Yujuan LI ; Yanfen DAI ; Hongyun LIU
Chinese Journal of Endocrine Surgery 2025;19(4):589-594
Objective:To investigate the value of tumor volume to uterine volume ratio (N/U) combined with the expression of alpha-fetoprotein (AFP), sugar antigen 199 (CA199) and human epididymal secretory protein 4 (HE4) in evaluating the pathologic grade and prognosis of endometrial carcinoma (EC) .Methods:A total of 160 EC patients admitted to Linyi Central Hospital from Jan. 2021 to Dec. 2023 were divided into low-grade group and high-grade group according to FIGO grading method, and were divided into poor prognosis group and good prognosis group according to cancer death, recrudescence. The levels of N/U, AFP, CA199 and HE4 in patients with different pathologic grades and prognosis were compared. COX regression was used to analyze the influencing factors of EC adverse prognosis, ROC curve was used to analyze the value of N/U combined with serum AFP, CA199 and HE4 in predicting EC adverse prognosis, and a nomogram model was constructed.Results:Pathological examination of 160 EC patients showed that 12 cases were non-endometrioid adenocarcinoma, 148 cases were endometrioid adenocarcinoma, 41 cases were high-grade and 119 cases were low-grade.According to the follow-up, 94 of the 160 EC patients had good prognosis and 66 had poor prognosis. The levels of N/U, AFP, CA199 and HE4 in the poor prognosis group were higher than those in the good prognosis group ( P<0.05). COX regression analysis showed that high levels of N/U, AFP, CA199 and HE4 were all factors affecting the poor prognosis of EC patients ( P<0.05). The AUC value of combined detection of N/U, AFP, CA199 and HE4 in predicting adverse prognosis of EC patients was higher than that of single detection ( Z=3.140, 3.658, 4.277, 4.378, P<0.05) .The ROC curve AUC (95% CI) of the training set and the validation set were 0.84 (0.77-0.92) and 0.90 (0.81-0.98) respectively for the training set and the validation set to predict the adverse prognosis of EC patients. Calibration curve results showed that the calibration curve for EC patients predicted by the nomogram model was close to the ideal curve ( P=0.521, 0.743). The DCA curve shows that the probability threshold of the nomogram model has a higher positive net return at 20%~100%. Conclusion:The levels of N/U, AFP, CA199 and HE4 in EC patients are related to the pathologic grade, and the combined detection of these indicators can predict the poor prognosis of EC patients, and the nomogram model constructed based on these indicators has high predictive value.
5.The relationships between the expression of osteopontin and esophageal squamous cell carcinoma and its clinicopathologic feature: A Meta-analysis
Yujuan DAI ; Enhuan ZHANG ; Dachao CHEN
China Medical Equipment 2017;14(6):92-97
Objective:To systematic review the relationships between the expression of osteopontin (OPN) and esophageal squamous cell carcinoma and its clinicopathologic feature with meta-analyses.Methods: The published studies in the PubMed, the Cochrane Library, EMbase, CBM, CNKI, VIP and WanFang databases were searched, at the time, the documents retrospective method was adopted, and then a series researches about the relationships between the expression of OPN and esophageal squamous cell carcinoma and its clinicopathologic feature were collected. The Jan., 2017 was the deadline of search. The study arranged two researcher to screen documents as the standards of inclusion and exclusion, and extract data and evaluate the quality of methodology for these included documents. The RevMan 5.2 was applied to analyze these data in this Meta analysis.Results: A total of 12 case control studies were included, which included 782 cases of esophageal squamous cell carcinoma in case group and 700 persons in control group. The results of Meta analysis showed the OR of the expression of OPN between cases group and control group was 52.71, and its 95% confidence interval (CI) was 17.95-154.79. Besides, the OR of the expression of OPN between clinical Ⅰ-Ⅱ stage group and clinical Ⅲ-Ⅳ stage group was 0.20, and its 95% (CI) was 0.07-0.60. The OR of the expression of OPN between group with lymph node metastasis and group without lymph node metastasis was 6.37, and its CI was 3.64-11.15. The OR of the expression of OPN between T1+T2 group and T3+T4 group was 0.31, and its 95% (CI) was 0.15-0.64. The differences of the expression of OPN among various group had statistically significant.Conclusion:Current evidence indicates that the expression level of OPN is significantly correlated with esophageal squamous cell carcinoma and its clinicopathologic features. Due to the limited quantity of documents and quality of included studies, above conclusions need to be verified by conducting more high quality studies.
6.Inhibitory effect of NRP-1 b1/b2 monoclonal antibody on invasion and migration of gastric cancer cell line BGC-823 and its mechanism
Yuan DING ; Peng GAO ; Juan ZHOU ; Yujuan DAI ; Yuqiang CHEN ; Jianghua YAN ; Lijing CHEN
Cancer Research and Clinic 2017;29(11):726-730
Objective To observe the effect of anti NRP-1 b1/b2 monoclonal antibody (NRP-1mAb) on migration and invasion of gastric cancer cell line BGC-823, and to explore the possible mechanism. Methods NRP-1mAb was prepared in the laboratory, and the purity of antibody was detected by flow cytometry. The different concentrations of NRP-1mAb were added into the culture medium of gastric cancer cell line BGC-823. The migration and invasion of cells after 12 hours was observed by using Transwell method. The phosphorylation of related signal proteins after NRP-1mAb was detected by Western blot analysis. Results When NRP-1mAb prepared by patented technology had the effects on BGC-823 cells after 12 hours, the number of migration and invasion of BGC-823 cells was reduced. The number of cells through the basement membrane in the control group (blank) and the administration group (NRP-1mAb 25, 100, 400 μg / ml) were 167 ± 9, 138 ± 5, 98 ± 5, 36 ± 4, respectively (F = 22.6, P< 0.01); the number of cells through the filtration membrane were 231 ± 40,224 ± 19,176 ± 26,124 ± 34,respectively(F=26.63,P<0.01). There were statistically significant differences between the administered group and the control group at 100 and 400 μg/ml (all P< 0.001). High concentration of NRP-1mAb (100 μg/ml) decreased the phosphorylation level of Akt after 10 minutes' function on gastric cancer cells. However, it was difficult to detect phosphorylated Akt after 30 minutes. Conclusion NRP-1mAb may inhibit the migration and invasion of gastric cancer cell line BGC-823 by decreasing the phosphorylation of Akt, which is positively correlated with the concentration.
7.Correlation analysis on clinical learning environment and stress among nursing students during initial period of clinical practice
Yanling LI ; Hui DAI ; Fang CHENG ; Yujuan WANG ; Haichun YAN
Chinese Journal of Modern Nursing 2017;23(4):570-574
Objective To explore the status of clinical learning environment and stress among nursing students during initial period of clinical practice and analyze the correlation between them.Methods With purpose sampling method,219 nursing students,who did rotating practice in eight departments of Beijing Electric Power Hospital of State Grid from July 2015 to February 2016 were selected and surveyed by clinical learning environment assessment scale and practice stress scale.Results The nursing students' assessment on clinical learning environment was (172.99±19.36) points,and the average score of entries was (4.12±0.51). Scores of various dimensions with a descending order were:interpersonal relationship (4.31±0.50),working environment and teamwork spirit (4.25±0.50),task orientation (4.23±0.47),innovation (4.11±0.52),students' involvement (4.06±0.51),and individuality (3.51±0.86). Scores of the nursing students' perceived stress during initial period of practice were (31.89±13.94) points,with average score of (1.10±0.48). Scores of stress sources with a descending order were:lack of professional knowledge and skills (1.44±0.61) points,taking care of patients (1.33±0.55),assignments and workload (1.19±0.60),clinical environment (0.93±0.52),clinical teachers (0.88±0.53),and companions and daily life (0.75±0.55). Perceived stress had a negative correlation with learning environment (r=-0.160,P<0.05).Conclusions The more satisfied to the clinical learning environment,the less stress the students perceive;it is recommended that students' learning environment should be improved,so as to relieve their perceived stress during clinical practice and improve quality of nursing education.
8.Role of zinc finger protein 1 in rat liver fibrosis and as related to TGFb expression.
Yujuan SHEN ; Yongping CHEN ; Zhenzhen LIU ; Xiaodong WANG ; Chunlei DAI ; Zhuo LIN
Chinese Journal of Hepatology 2014;22(4):285-288
OBJECTIVETo determine the role of zinc finger protein 1 (ZEB 1) in liver fibrosis and in regards to expression of the tumor growth factor-beta (TGFb) signaling factor using a rat model system.
METHODSSprague-Dawley rats were randomly divided into a normal (control) group, liver fibrosis (model) group and a liver fibrosis + therapy (ZEB1 intervention) group. The model group and the ZEB1 intervention group were given intraperitoneal injections of dimethylnitrosamine (DMN) for the first 3 days of each week over a 7-week period; starting at week 5, the ZEB 1 intervention group was started on a routine of every other day tail vein injections of recombinant ZEB1. During this 7-week period, the control group was given intraperitoneal injections of 0.9% NaC1 alone on the DMN schedule. Liver tissues were collected for pathological examination (with hematoxylin-eosin and Masson staining) and for detection of TGFb1 and ZEB 1 expression (by RT-PCR and western blotting). Measurement data were compared between groups using the single-factor analysis of variance test, followed by the least significant difference LSD test. Count data were analyzed by Fisher's exact test.
RESULTSThe model group's liver tissues showed degeneration and necrosis, as well as obvious fibrous septa accompanied by pseudo lobules. The ZEB 1 intervention group's liver tissues showed a significantly higher degree of fibrosis (x²=21.63, P=0), with more coarse fiber cords. The expression of ZEB1 and TGFb1 was significantly higher in the model group than in the control group (both P less than 0.05). However, the ZEB 1 intervention group showed the highest levels of ZEB 1 and TGFb1 expression (vs. model group, P less than 0.05).
CONCLUSIONZEB 1 may promote the development of liver fibrosis in rats through a mechanism involving the TGFb/Smad signaling pathway.
Animals ; Homeodomain Proteins ; pharmacology ; Liver ; drug effects ; metabolism ; Liver Cirrhosis, Experimental ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Transcription Factors ; pharmacology ; Transforming Growth Factor beta1 ; metabolism ; Zinc Fingers

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