• 제목/요약/키워드: Prognostic models

검색결과 89건 처리시간 0.024초

Prognostic Value of Coronary CT Angiography for Predicting Poor Cardiac Outcome in Stroke Patients without Known Cardiac Disease or Chest Pain: The Assessment of Coronary Artery Disease in Stroke Patients Study

  • Sung Hyun Yoon;Eunhee Kim;Yongho Jeon;Sang Yoon Yi;Hee-Joon Bae;Ik-Kyung Jang;Joo Myung Lee;Seung Min Yoo;Charles S. White;Eun Ju Chun
    • Korean Journal of Radiology
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    • 제21권9호
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    • pp.1055-1064
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    • 2020
  • Objective: To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison to a clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemic stroke patients without chest pain. Materials and Methods: This retrospective study included 1418 patients with acute stroke who had no previous cardiac disease and underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) were assessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed: low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognostic value of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS. Results: The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis ≥ 50%) were 70.7% and 30.2%, respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS, and stenosis degree were positively associated with MACE (all p < 0.05). Patients with high-risk plaque type showed the highest incidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p < 0.001). Among the prediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared to FRS or the FRS + CACS model (all p < 0.05). Furthermore, incorporating plaque type in the prediction model significantly improved reclassification (integrated discrimination improvement, 0.08; p = 0.023) and showed the highest discrimination index (C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p > 0.05). Conclusion: Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS and FRS to risk stratify stroke patients without prior history of CAD better.

Analytical Rapid Prediction of Tsunami Run-up Heights: Application to 2010 Chilean Tsunami

  • Choi, Byung Ho;Kim, Kyeong Ok;Yuk, Jin-Hee;Kaistrenko, Victor;Pelinovsky, Efim
    • Ocean and Polar Research
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    • 제37권1호
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    • pp.1-9
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    • 2015
  • An approach based on the combined use of a 2D shallow water model and analytical 1D long wave run-up theory is proposed which facilitates the forecasting of tsunami run-up heights in a more rapid way, compared with the statistical or empirical run-up ratio method or resorting to complicated coastal inundation models. Its application is advantageous for long-term tsunami predictions based on the modeling of many prognostic tsunami scenarios. The modeling of the Chilean tsunami on February 27, 2010 has been performed, and the estimations of run-up heights are found to be in good agreement with available observations.

Survival Prognostic Factors of Male Breast Cancer in Southern Iran: a LASSO-Cox Regression Approach

  • Shahraki, Hadi Raeisi;Salehi, Alireza;Zare, Najaf
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6773-6777
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    • 2015
  • We used to LASSO-Cox method for determining prognostic factors of male breast cancer survival and showed the superiority of this method compared to Cox proportional hazard model in low sample size setting. In order to identify and estimate exactly the relative hazard of the most important factors effective for the survival duration of male breast cancer, the LASSO-Cox method has been used. Our data includes the information of male breast cancer patients in Fars province, south of Iran, from 1989 to 2008. Cox proportional hazard and LASSO-Cox models were fitted for 20 classified variables. To reduce the impact of missing data, the multiple imputation method was used 20 times through the Markov chain Mont Carlo method and the results were combined with Rubin's rules. In 50 patients, the age at diagnosis was 59.6 (SD=12.8) years with a minimum of 34 and maximum of 84 years and the mean of survival time was 62 months. Three, 5 and 10 year survival were 92%, 77% and 26%, respectively. Using the LASSO-Cox method led to eliminating 8 low effect variables and also decreased the standard error by 2.5 to 7 times. The relative efficiency of LASSO-Cox method compared with the Cox proportional hazard method was calculated as 22.39. The19 years follow of male breast cancer patients show that the age, having a history of alcohol use, nipple discharge, laterality, histological grade and duration of symptoms were the most important variables that have played an effective role in the patient's survival. In such situations, estimating the coefficients by LASSO-Cox method will be more efficient than the Cox's proportional hazard method.

Season of Diagnosis and Survival of Advanced Lung Cancer Cases - Any Correlation?

  • Oguz, Arzu;Unal, Dilek;Kurtul, Neslihan;Aykas, Fatma;Mutlu, Hasan;Karagoz, Hatice;Cetinkaya, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.4325-4328
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    • 2013
  • Introduction: The influence of season at diagnosis on cancer survival has been an intriguing issue for many years. Most studies have shown a possible correlation in between the seasonality and some cancer type survival. With short expected survival, lung cancer is an arena that still is in need of new prognostic factors and models. We aimed to investigate the effect of season of diagnosis on 3 months, 1 and 2 years survival rates and overall survival of non small cell lung cancer patients. Materials and Methods: The files of non small cell lung cancer patients that were stages IIIB and IV at diagnosis were reviewed retrospectively. According to diagnosis date, the patients were grouped into 4 season groups, autumn, winter, spring and summer. Results: A total of 279 advanced non small cell lung cancer patients' files were reviewed. Median overall survival was 15 months in the entire population. Overall 3 months, 1 and 2 years survival rates were 91.0%, 58.2% and 31.2% respectively. The season of diagnosis was significantly correlated with 3 months survival rates, being diagnosed in spring being associated with better survival. Also the season was significantly correlated with T stage of the disease. For 1 and 2 years survival rates and overall survival, the season of diagnosis was not significantly correlated. There was no correlation detected between season and overall survivals according to histological subtypes of non small cell lung cancer. Conclusion: As a new finding in advanced non small cell lung cancer patients, it can be concluded that being diagnosed in spring can be a favorable prognostic factor for short term survival.

Overexpression of Matrix Metalloproteinase 11 in Thai Prostatic Adenocarcinoma is Associated with Poor Survival

  • Nonsrijun, Nongnuch;Mitchai, Jumphol;Brown, Kamoltip;Leksomboon, Ratana;Tuamsuk, Panya
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.3331-3335
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    • 2013
  • Background: The incidence of prostate cancer, one of the most common cancers in elderly men, is increasing annually in Thailand. Matrix metalloproteinase 11 (MMP-11) is a member of the extracellular matrix metalloproteases which has been associated with human tumor progression and clinical outcome. Aim: To quantify MMP-11 expression in prostatic adenocarcinoma tissues and to determine whether its overexpression correlates with survival outcome, and to assess its potential as a new prognostic marker. Materials and Methods: Expression of MMP-11 was analyzed using immunohistochemistry in 103 Thai patients with prostatic adenocarcinoma. Overall survival was analyzed using Kaplan-Meier methods and Cox regression models. Results: Immunoreactivity of MMP-11 was seen in the stroma of prostatic adenocarcinoma tissue samples, high expression being significantly correlated with poor differentiation in Gleason grading, pathologic tumor stage 4 (pT4), and positive-bone metastasis (p<0.05), but not age and prostatic-specific antigen (PSA) level. Patients with high levels of MMP-11 expression demonstrated significantly shorter survival (p<0.001) when compared to those with low levels. Multivariate analysis showed that MMP-11 expression and pT stage were related with survival in prostatic adenocarcinoma [hazard ratio (HR)=0.448, 95% confidence interval (95%CI)=0.212-0.946, HR=0.333, 95%CI=0.15-0.74, respectively]. Conclusions: Expression of MMP-11 is significantly associated with survival in prostatic adenocarcinoma. High levels may potentially be used for prediction of a poor prognosis.

Lectin from Agrocybe aegerita as a Glycophenotype Probe for Evaluation of Progression and Survival in Colorectal Cancer

  • Liang, Yi;Chen, Hua;Zhang, Han-Bin;Jin, Yan-Xia;Guo, Hong-Qiang;Chen, Xing-Gui;Sun, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5601-5605
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    • 2014
  • Background: Agrocybe aegerita Lectin (AAL) has been identified to have high affinity for sulfated and ${\alpha}2$-3-linked sialic acid glycoconjugates, especially the sulfated and sialyl TF (Thomsen-Friedenreich) disaccharide. This study was conducted to investigate the clinicopathological and prognostic value of AAL in identifying aberrant glycosylation in colorectal cancer (CRC). Materials and Methods: Glycoconjugate expression in 59 CRC tissues were detected using AAL-histochemistry. Clinicopathological associates of expression were analyzed with chisquare test or Fisher's exact test. Relationships between expression and the various clinicopathological parameters was estimated using Kaplan-Meier analysis and Cox regression models. Results: AAL specific glycoconjugate expression was significantly higher in tumor than corresponding normal tissues (66.1% and 46.1%, respectively, p=0.037), correlating with depth of invasion (p=0.015) and TNM stage (p=0.024). Patients with lower expression levels had a significantly higher survival rate than those with higher expression (p=0.046 by log rank test and p=0.047 by Breslow test for overall survival; p=0.054 by log rank test and P=0.038 by Breslow test for progress free survival). A marginally significant association was found between AAL specific glycoconjugate expression and overall survival by univariate Cox regression analysis (p=0.059). Conclusions: Lower AAL specific glycoconjugate expression is a significant favorable prognostic factor for overall and progress free survival in CRC. This is the first report about the employment of AAL for histochemical analysis of cancer tissues. The binding characteristics of AAL means it has potential to become a powerful tool for the glycan investigation and clinical application.

대기예보모형과 진단모형 결합을 통한 복잡지형 바람장 해석능력 평가 (Skillful Wind Field Simulation over Complex Terrain using Coupling System of Atmospheric Prognostic and Diagnostic Models)

  • 이화운;김동혁;이순환;김민정;박순영;김현구
    • 한국환경과학회지
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    • 제19권1호
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    • pp.27-37
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    • 2010
  • A system coupled the prognostic WRF mesoscale model and CALMET diagnostic model has been employed for predicting high-resolution wind field over complex coastal area. WRF has three nested grids down to from during two days from 24 August 2007 to 26 August 2007. CALMET simulation is performed using both initial meteorological field from WRF coarsest results and surface boundary condition that is Shuttle Radar Topography Mission (SRTM) 90m topography and Environmental Geographic Information System (EGIS) 30m landuse during same periods above. Four Automatic Weather System (AWS) and a Sonic Detection And Ranging (SODAR) are used to verify modeled wind fields. Horizontal wind fields in CM_100m is not only more complex but better simulated than WRF_1km results at Backwoon and Geumho in which there are shown stagnation, blocking effects and orographically driven winds. Being increased in horizontal grid spacing, CM_100m is well matched with vertically wind profile compared SODAR. This also mentions the importance of high-resolution surface boundary conditions when horizontal grid spacing is increased to produce detailed wind fields over complex terrain features.

귀밑샘 암종에서 생존 예측을 위한 임상병리 인자 분석 및 머신러닝 모델의 구축 (Clinico-pathologic Factors and Machine Learning Algorithm for Survival Prediction in Parotid Gland Cancer)

  • 곽승민;김세헌;최은창;임재열;고윤우;박영민
    • 대한두경부종양학회지
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    • 제38권1호
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    • pp.17-24
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    • 2022
  • Background/Objectives: This study analyzed the prognostic significance of clinico-pathologic factors including comprehensive nodal factors in parotid gland cancers (PGCs) patients and constructed a survival prediction model for PGCs patients using machine learning techniques. Materials & Methods: A total of 131 PGCs patients were enrolled in the study. Results: There were 19 cases (14.5%) of lymph nodes (LNs) at the lower neck level and 43 cases (32.8%) involved multiple level LNs metastases. There were 2 cases (1.5%) of metastases to the contralateral LNs. Intraparotid LNs metastasis was observed in 6 cases (4.6%) and extranodal extension (ENE) findings were observed in 35 cases (26.7%). Lymphovascular invasion (LVI) and perineural invasion findings were observed in 42 cases (32.1%) and 49 cases (37.4%), respectively. Machine learning prediction models were constructed using clinico-pathologic factors including comprehensive nodal factors and Decision Tree and Stacking model showed the highest accuracy at 74% and 70% for predicting patient's survival. Conclusion: Lower level LNs metastasis and LNR have important prognostic significance for predicting disease recurrence and survival in PGCs patients. These two factors were used as important features for constructing machine learning prediction model. Our machine learning model could predict PGCs patient's survival with a considerable level of accuracy.

Prognostic Role of Hepatoma-derived Growth Factor in Solid Tumors of Eastern Asia: a Systematic Review and Meta-Analysis

  • Bao, Ci-Hang;Liu, Kun;Wang, Xin-Tong;Ma, Wei;Wang, Jian-Bo;Wang, Cong;Jia, Yi-Bin;Wang, Na-Na;Tan, Bing-Xu;Song, Qing-Xu;Cheng, Yu-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권5호
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    • pp.1803-1811
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    • 2015
  • Hepatoma-derived growth factor (HDGF) is a novel jack-of-all-trades in cancer. Here we quantify the prognostic impact of this biomarker and assess how consistent is its expression in solid tumors. A comprehensive search strategy was used to search relevant literature updated on October 3, 2014 in PubMed, EMBASE and WEB of Science. Correlations between HDGF expression and clinicopathological features or cancer prognosis was analyzed. All pooled HRs or ORs were derived from random-effects models. Twenty-six studies, primarily in Eastern Asia, covering 2,803 patients were included in the analysis, all of them published during the past decade. We found that HDGF overexpression was significantly associated with overall survival (OS) ($HR_{OS}=2.35$, 95%CI=2.04-2.71, p<0.001) and disease free survival (DFS) ($HR_{DFS}=2.25$, 95%CI =1.81-2.79, p<0.001) in solid tumors, especially in non-small cell lung cancer, hepatocellular carcinoma and cholangiocarcinoma (CCA). Moreover, multivariate survival analysis showed that HDGF overexpression was an independent predictor of poor prognosis ($HR_{OS}=2.41$, 95%CI: 2.02-2.81, p<0.001; $HR_{DFS}=2.39$, 95%CI: 1.77-3.24, p<0.001). In addition, HDGF overexpression was significantly associated with tumor category (T3-4 versus T1-2, OR=2.12, 95%CI: 1.17-3.83, p=0.013) and lymph node status (N+ versus N-, OR=2.37, 95%CI: 1.31-4.29, p=0.03) in CCA. This study provides a comprehensive examination of the literature available on the association of HDGF overexpression with OS, DFS and some clinicopathological features in solid tumors. Meta-analysis results provide evidence that HDGF may be a new indicator of poor cancer prognosis. Considering the limitations of the eligible studies, other large-scale prospective trials must be conducted to clarify the prognostic value of HDGF in predicting cancer survival.

Survival Rate and Prognostic Factors of Esophageal Cancer in East Azerbaijan Province, North-west of Iran

  • Mirinezhad, Seyed Kazem;Somi, Mohammad Hossein;Jangjoo, Amir Ghasemi;Seyednezhad, Farshad;Dastgiri, Saeed;Mohammadzadeh, Mohammad;Naseri, Ali Reza;Nasiri, Behnam
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3451-3454
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    • 2012
  • Background: Esophageal cancer in Iran is the sixth most common cancer and is particularly important in east Azerbaijan. The aim of this study was to calculate survival rates and define prognostic factors in esophageal cancer patients. Methods: In this study, all patients with esophageal cancer registered in the Radiation Therapy Center, during March 2006 to March 2011, were analyzed and followed up for vital status. Data were analyzed using the Kaplan-Meier method and the Cox proportional hazard models. Results: Out of 532 patients, survival information was available for 460, including 205 (44/ 5%) females and 255 (55/4%) males. The mean age was $65.8{\pm}12.2$, ranging from 29 to 90 years at the time of diagnosis. 1-, 3- and 5-year survival rates after diagnosis were 55%, 18% and 12%, respectively, with a median survival time of $13.2{\pm}.7$ (CI 95% =11.8-14.6) months. In the univariate analysis, age (P=0/001), education (P=0/001), smoking status (P= 0/001), surgery (P= 0/001), tumor differentiation (P= 0/003) and tumor stage (P= 0/001) were significant prognostic factors. Tumor morphology, sex, place of residence, tumor histology and tumor location did not show any significant effects on the survival rate. In multivariate analysis, age (P = 0/003), smoking (P= 0/01) and tumor stage (P= 0/001) were significant independent predictors of survival. Conclusion: In summary, prognosis of esophageal cancer in North West of Iran is poor. Therefore, reduction in exposure to risk factors and early detection should be emphasized to improve survival.