Objective. Several authors have proposed the use of a less aggressive surgery (i.e., modified or type 2 radical hysterectomy) for patients affected by early stages cervical carcinoma. However, little attention has bee...Objective. Several authors have proposed the use of a less aggressive surgery (i.e., modified or type 2 radical hysterectomy) for patients affected by early stages cervical carcinoma. However, little attention has been given to the evaluation of adverse prognostic factors before selecting the surgical approach. The aim of this study is to evaluate the feasibility and safety of tailoring parametrectomy on the basis of specific prognostic factors preoperatively assessed. Methods. Patients with cervical carcinoma FIGO IA2- IB1 entered the study. Eligibility criteria were: age < 75 years, no contraindications for surgery, informed consent, expected cooperation for follow- up. Tumor size was preoperatively assessed by pelvic examination under anesthesia and pelvic MRI. Patients were submitted to systematic lymphadenectomy of superficial obturator, external iliac, and interiliac nodes by laparotomy or laparoscopy. Lymph nodes were sent for frozen section. Node- negative patients were submitted to modified radical hysterectomy (type 2). Patients with nodal metastases underwent classical radical hysterectomy (types 3- 4) and systematic pelvic and aortic node dissection up to the inferior mesenteric artery. Survival rates were calculated using the Kaplan- Meier product- limit method. Results. Eighty- three patients were enrolled in the study. Among these, 63 patients were node- negative at frozen section, and therefore submitted to modified radical hysterectomy (Group A); 20 patients were found having nodal metastases intra- opera- tively, and therefore submitted to classical radical hysterectomy (Group B). Median follow up was 30 months. Five years overall survival was 95% for Group A, and 74% for Group B. Conclusions. Pre- treatment evaluation of adverse prognostic factors in patients affected by cervical cancer FIGO stages IA2- IB1 is feasible and mandatory to determine if a less radical surgery is applicable and safe.展开更多
Protein homo-oligomers play an important role in various vital activities. Successful prediction of protein homo-oligomers directly from primary sequence is very beneficial to understand their protein function. In thi...Protein homo-oligomers play an important role in various vital activities. Successful prediction of protein homo-oligomers directly from primary sequence is very beneficial to understand their protein function. In this paper, a total of 14 238 homo-oligomeric protein sequences are predicted by IB1 algorithm. 10-fold cross-validation test is applied to test the predictive capability of the proposed method. The predictive results show that overall prediction accuracy is 90.46%, which is at least 9% higher than that of previous results; furthermore,the sensitivity and Matthew＇s correlation coefficient for each class of homo-oligomers are also improved significantly. The results show that IB1 algorithm is effective and feasible,and very suitable for predicting protein homo-oligomer types.展开更多
To compare stages IB1and IB2cervical cancers treated with radical hysterectomy (RH)and to define predictors of nodal status and recurrence.Patien ts with stage IB cervical cancers undergoing RH between 1990a nd 2000we...To compare stages IB1and IB2cervical cancers treated with radical hysterectomy (RH)and to define predictors of nodal status and recurrence.Patien ts with stage IB cervical cancers undergoing RH between 1990a nd 2000were e-valuated and clinicopathological v ariables were abstracted.The perioperative complication rate,estimated blood loss(EBL),and OR time were also tabulated.Variables were analyzed usingχ 2 and t tests.Disease -free survival(DFS)was calculated by Kaplan -Meier meth od.Multi-variate analysis was performed via s tepwise logistic regres-sion.Cox -proportional hazards were used to identify in-dependent predictors of recurrence.RH was performed on109stage IB1and 86stage IB2patient s.Mean age,EBL,and perioperative complication rates were similar.Overall,38patients(14IB1vs.24IB2)had positive nodes(P =0.01)including 9patients with positive p ara -aortic nodes(2IB1and 7IB2).Parametrial involvement (PI )and outer 2/3depth of invasion(DOI )were significantly more common in the IB2tumors as well.Patients with IB2dis-ease received adjuvant radiation mo re frequently than IB1patients(52%vs.37%,P =0.04).Univariate predic-tors of nodal status included lymphovascular space in-volvement (LVSI )(P =0.001),DOI (P =0.011),PI (P =0.001),and stage(P =0.011).Multivariate analysis identified only LVSI (OR 6.4,CI 2.4-17,P =0.0002)and PI (OR 8,CI 3.1-20,P =0.0001)as independent predictors of positive nodes.With a median follow -up of 35months,estimates of DFS revealed tumor size(P =0.008),nodal status(P =0.0004),LVSI (P =0.002),PI (P =0.004),and DOI (P =0.0004)as significant univariate predictors.Neoadjuvant chemothera-py,age,grade,histology,and adjuvant radiation were not associated with recurrence.The significant indepen-dent predictors of DFS were LVSI (ROR 5.7,CI 2-16,P =0.0064)and outer 2/3DOI (OR 5.8,CI 2-20,P =0.0029).Neither tumor size nor nodal status was a significant predictor of DFS.The pr ognosis in stage IB cervical cancer seems to be most infl uenced by presence of LVSI and DOI and not by tumor size as th e s展开更多
文摘Objective. Several authors have proposed the use of a less aggressive surgery (i.e., modified or type 2 radical hysterectomy) for patients affected by early stages cervical carcinoma. However, little attention has been given to the evaluation of adverse prognostic factors before selecting the surgical approach. The aim of this study is to evaluate the feasibility and safety of tailoring parametrectomy on the basis of specific prognostic factors preoperatively assessed. Methods. Patients with cervical carcinoma FIGO IA2- IB1 entered the study. Eligibility criteria were: age < 75 years, no contraindications for surgery, informed consent, expected cooperation for follow- up. Tumor size was preoperatively assessed by pelvic examination under anesthesia and pelvic MRI. Patients were submitted to systematic lymphadenectomy of superficial obturator, external iliac, and interiliac nodes by laparotomy or laparoscopy. Lymph nodes were sent for frozen section. Node- negative patients were submitted to modified radical hysterectomy (type 2). Patients with nodal metastases underwent classical radical hysterectomy (types 3- 4) and systematic pelvic and aortic node dissection up to the inferior mesenteric artery. Survival rates were calculated using the Kaplan- Meier product- limit method. Results. Eighty- three patients were enrolled in the study. Among these, 63 patients were node- negative at frozen section, and therefore submitted to modified radical hysterectomy (Group A); 20 patients were found having nodal metastases intra- opera- tively, and therefore submitted to classical radical hysterectomy (Group B). Median follow up was 30 months. Five years overall survival was 95% for Group A, and 74% for Group B. Conclusions. Pre- treatment evaluation of adverse prognostic factors in patients affected by cervical cancer FIGO stages IA2- IB1 is feasible and mandatory to determine if a less radical surgery is applicable and safe.
基金Supported by the Discipline-Crossing Research Foundation of Huazhong Agricultural University (2008XKJC006)
文摘Protein homo-oligomers play an important role in various vital activities. Successful prediction of protein homo-oligomers directly from primary sequence is very beneficial to understand their protein function. In this paper, a total of 14 238 homo-oligomeric protein sequences are predicted by IB1 algorithm. 10-fold cross-validation test is applied to test the predictive capability of the proposed method. The predictive results show that overall prediction accuracy is 90.46%, which is at least 9% higher than that of previous results; furthermore,the sensitivity and Matthew＇s correlation coefficient for each class of homo-oligomers are also improved significantly. The results show that IB1 algorithm is effective and feasible,and very suitable for predicting protein homo-oligomer types.
文摘To compare stages IB1and IB2cervical cancers treated with radical hysterectomy (RH)and to define predictors of nodal status and recurrence.Patien ts with stage IB cervical cancers undergoing RH between 1990a nd 2000were e-valuated and clinicopathological v ariables were abstracted.The perioperative complication rate,estimated blood loss(EBL),and OR time were also tabulated.Variables were analyzed usingχ 2 and t tests.Disease -free survival(DFS)was calculated by Kaplan -Meier meth od.Multi-variate analysis was performed via s tepwise logistic regres-sion.Cox -proportional hazards were used to identify in-dependent predictors of recurrence.RH was performed on109stage IB1and 86stage IB2patient s.Mean age,EBL,and perioperative complication rates were similar.Overall,38patients(14IB1vs.24IB2)had positive nodes(P =0.01)including 9patients with positive p ara -aortic nodes(2IB1and 7IB2).Parametrial involvement (PI )and outer 2/3depth of invasion(DOI )were significantly more common in the IB2tumors as well.Patients with IB2dis-ease received adjuvant radiation mo re frequently than IB1patients(52%vs.37%,P =0.04).Univariate predic-tors of nodal status included lymphovascular space in-volvement (LVSI )(P =0.001),DOI (P =0.011),PI (P =0.001),and stage(P =0.011).Multivariate analysis identified only LVSI (OR 6.4,CI 2.4-17,P =0.0002)and PI (OR 8,CI 3.1-20,P =0.0001)as independent predictors of positive nodes.With a median follow -up of 35months,estimates of DFS revealed tumor size(P =0.008),nodal status(P =0.0004),LVSI (P =0.002),PI (P =0.004),and DOI (P =0.0004)as significant univariate predictors.Neoadjuvant chemothera-py,age,grade,histology,and adjuvant radiation were not associated with recurrence.The significant indepen-dent predictors of DFS were LVSI (ROR 5.7,CI 2-16,P =0.0064)and outer 2/3DOI (OR 5.8,CI 2-20,P =0.0029).Neither tumor size nor nodal status was a significant predictor of DFS.The pr ognosis in stage IB cervical cancer seems to be most infl uenced by presence of LVSI and DOI and not by tumor size as th e s
基金National Natural Science Foundation of China(No:31050015)Foundation of Jilin Education Department for Science and Technology Research in the"11th 5-year"Plan(No:2007174)
