Browsing Artikler, rapporter og annet (klinisk medisin) by Title
DSpace/Manakin Repository
- Home
- Det helsevitenskapelige fakultet
- Institutt for klinisk medisin
- Artikler, rapporter og annet (klinisk medisin)
- Browsing Artikler, rapporter og annet (klinisk medisin) by Title
Browsing Artikler, rapporter og annet (klinisk medisin) by Title
-
Haug, Bjørn; Kjelsberg, Kjærsti; Lappegård, Knut Tore (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Some countries have a demography that makes it necessary to maintain relatively small pacemaker centres. We wanted to assess the quality of pacemaker surgery in two such hospitals. Through patient records we gathered information on ∼535 consecutive primary pacemaker implantations in two small pacemaker centres with 30 and 80 annual operations, respectively. All patients were followed for 3 years. All complications documented in the patient records were registered. Furthermore, we performed a non-systematic literature search comparing our data with reports from major centres published over the last 10 years.We found 72 complications in 64 (12.0%) of the patients, the most common being bleeding, lead failure, and pneumothorax. If minor bleedings without any consequences for the patients are excluded, the number of complications was 46 in 40 patients (7.5%). We had to reoperate on 5.2% of the patients. There was no statistically significant difference in complication rates between the two hospitals. Education candidates generated statistically significant more complications than experienced doctors (13.7 vs. 7.1%, P < 0.05). There are no generally accepted norms of complication rates in pacemaker surgery. However, we found no indications that our centres have a rate of complications that is unacceptably high. URI: http://hdl.handle.net/10037/4110 File(s) in this item: 1
article.pdf (92.69Kb) -
Ozolina, A.; Strike, E.; Jaunalksne, I.; Krumina, A.; Bjertnaes, Lars J.; Vanags, I. (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Enhanced bleeding remains a serious problem after cardiac surgery, and fibrinolysis is often involved. We speculate that lower plasma concentrations of plasminogen activator inhibitor – 1 (PAI-1) preoperatively and tissue plasminogen activator/PAI-1 (t-PA/PAI-1) complex postoperatively might predispose for enhanced fibrinolysis and increased postoperative bleeding. Totally 88 adult patients (mean age 66 ± 10 years) scheduled for cardiac surgery, were enrolled into a prospective study. Blood samples were collected pre-operatively, on admission to the recovery and at 6 and 24 hours postoperatively. Patients with a surgical bleeding that was diagnosed during reoperation were discarded from the study. The patients were allocated to two groups depending on the 24-hour postoperative chest tube drainage (CTD): Group I > 500ml, Group II ≤ 500ml. Associations between CTD, PAI-1, t-PA/PAI-1 complex and D-dimer were analyzed with SPSS. Nine patients were excluded because of surgical bleeding. Of the 79 remaining patients, 38 were allocated to Group I and 41 to Group II. The CTD volumes correlated with the preoperative plasma levels of PAI-1 (r = − 0.3, P = 0.009). Plasma concentrations of preoperative PAI-1 and postoperative t-PA/PAI-1 complex differed significantly between the groups (P < 0.001 and P = 0.012, respectively). Group I displayed significantly lower plasma concentrations of fibrinogen and higher levels of D-dimer from immediately after the operation and throughout the first 24 hours postoperatively. Lower plasma concentrations of PAI-1 preoperatively and t-PA/PAI-1 complex postoperatively leads to higher plasma levels of D-dimer in association with more postoperative bleeding after cardiac surgery. URI: http://hdl.handle.net/10037/4887 File(s) in this item: 1
article.pdf (316.7Kb) -
Hjelmesæth, Jøran; Hofsø, Dag; Aasheim, Erlend T.; Jenssen, Trond Geir; Moan, Johan; Hager, Helle; Røislien, Jo; Bollerslev, Jens (Journal article; Tidsskriftartikkel; Peer reviewed, 03-Feb-2009)[+][-]
Abstract: Background: The prevalence of vitamin D insufficiency and secondary hyperparathyroidism is high among morbidly obese subjects. Further, low serum levels of 25-hydroxyvitamin D (25 [OH]D) and magnesium have been associated with increased risk of the metabolic syndrome (MS), and recently, a possible link between PTH and MS has been reported. Although it is well known that the synthesis and secretion of PTH is regulated by serum levels of calcium, phosphate, magnesium and 25(OH)D, less is known about the possible clustered affiliation of these parameters with MS. We aimed to explore whether MS is associated with abnormal serum levels of PTH, 25(OH)D and magnesium in a population of morbidly obese patients.
Methods: Fasting serum levels of 25(OH)D, PTH and magnesium were assessed in a cross-sectional cohort study of 1,017 consecutive morbidly obese patients (68% women). Multiple logistic regression analyses were used to assess the independent effect of PTH, 25(OH)D and magnesium on the odds for MS (National Cholesterol Education Program [NCEP]) after adjustment for confounding factors.
Results: Sixty-eight percent of the patients had MS. Patients with MS had lower mean serum magnesium (P < 0.001) and higher mean PTH (P = 0.067) than patients without MS, whereas mean 25(OH)D did not differ significantly. Patients with PTH levels in the second to fourth quartiles had higher odds of prevalent MS (odds ratio 1.47 [95% CI 0.92–2.35], 2.33 [95% CI 1.40–3.87] and 2.09 [95% CI 1.23–3.56], respectively), after adjustment for 25(OH)D, magnesium, calcium, phosphate, creatinine, age, gender, season of serum sampling, BMI, current smoking, albuminuria, CRP, insulin resistance and type 2 diabetes. Further, PTH was significantly correlated with systolic and diastolic pressure (both P < 0.001), but not with the other components of MS. The levels of 25(OH)D and magnesium were not associated with MS in the multivariate model.
Conclusion: The PTH level, but not the vitamin D level, is an independent predictor of MS in treatment seeking morbidly obese Caucasian women and men. Randomized controlled clinical trials, including different therapeutic strategies to lower PTH, e.g. calcium/vitamin D supplementation and weight reduction, are necessary to explore any cause-and-effect relationship.URI: http://hdl.handle.net/10037/2185 File(s) in this item: 1
article.pdf (297.6Kb) -
Krogstad, Unni; Gilbert, Mads; Ormstad, Sari Susanna; Rygh, Liv; Arntzen, Elisabeth; Baalsrud, Anders; Nilsen, Stein Tore (Research report; Forskningsrapport, 2007)[+][-]
Abstract: Helse Øst RHF har bedt Kunnskapssenteret om å vurdere dokumentasjonen for de seks satsingsområdene kampanjen fokuserer på: Etablere 'Rapid response team' (ekspertgruppe som tilkalles ved forverret tilstand hos pasienter) gjennomføre evidensbaserte behandlingstiltak for alle hjerteinfarktpasienter, forebygge legemiddelrelaterte pasientskader, forebygge postoperative sårinfeksjoner, forebygge respiratorassosierte lungebetennelse og forebygge alvorlige infeksjoner i forbindelse med sentralt venekateter."Pasientsikkerhet i sykehus – kunnskap eller kampanje?" (no english title) URI: http://hdl.handle.net/10037/3214 File(s) in this item: 1
article.pdf (595.7Kb) -
Norderhaug, Inger Natvig; Ingebrigsten, Tor; Krogstad, Unni; Søreide, Odd; Myhre, Hans Olav; Wiseth, Rune (Research report; Forskningsrapport, 2007)[+][-]
Abstract: Kunnskapssenteret har gjennomgått og sammenstilt forskningen om pasientvolum og behandlingskvalitet med grunnlag i litteratur for perioden 2001–2006. Denne delrapporten tar for seg behandling av hjerte- og karsykdommer.The influence of hospital or physician volume on qality of health care URI: http://hdl.handle.net/10037/3215 File(s) in this item: 1
article.pdf (816.4Kb) -
Aarsæther, Erling Johan; Røsner, Assami; Straumbotn, Espen; Busund, Rolf (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: The extension and the transmurality of the myocardial infarction are of high predictive value for clinical outcome. The aim of the study was to characterize the ability of longitudinal, circumferential and radial strain measured by 2-dimensional speckle tracking echocardiography (2D-STE) to predict the extent of necrosis in myocardial segments following acute myocardial infarction and to separate transmural necrotic segments from non-transmural necrotic segments in a full 18-segment porcine model. Methods 2D-STE strain was assessed in long- and short-axis following myocardial infarction in ten open-chest anesthetized pigs. Strain was defined according to systolic peak values. In segments displaying both negative and positive peaks, only the peak with the highest absolute value was utilized. Necrosis was measured by 2,3,5-triphenyltetrazolium chloride (TTC) staining and expressed as percent of each myocardial segment. Results Significant correlations were found between the extension of necrosis and all measured parameters of myocardial deformation (p < 0.001), but was stronger for longitudinal strain (r2 = 0.52) than circumferential strain (r2 = 0.38) and radial strain (r2 = 0.23). The area under the receiver operator characteristic curve (AUC) for separating transmural necrotic segments (>50% necrosis) from predominantly viable segments (0–50% necrosis) was significantly larger for longitudinal strain (AUC = 0.98, CI = 0.97–1.00) when compared with circumferential strain (AUC = 0.91, CI = 0.84–0.97, p < 0.05) and radial strain (AUC = 0.90, CI = 0.83 – 0.96, p < 0.01), indicating a stronger ability of longitudinal strain to identify segments with transmural necrosis. Conclusion Peak strain values derived from 2D-STE correlate well with the extent of necrosis in myocardial segments following acute myocardial infarction. Longitudinal strain most accurately reflects myocardial segmental viability in this setting. URI: http://hdl.handle.net/10037/4855 File(s) in this item: 1
article.pdf (1.023Mb) -
Borch, Knut Håkon; Hansen-Krone, Ida; Brækkan, Sigrid Kufaas; Mathiesen, Ellisiv B.; Njølstad, Inger; Wilsgaard, Tom; Hansen, John-Bjarne (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
-
Kummervold, Per Egil; Johnsen, Jan-Are Kolset (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Patients want to use electronic communication to access health services more easily. Health authorities in several countries see this as a way to improve health care. Physicians appear to have conflicting opinions regarding the suitability of electronic communication in clinical settings. The aim of our study was to measure how long it actually takes physicians to answer questions from patients through an electronic communication channel, and whether some of the questions are especially time consuming. We monitored electronic patient–physician communication. A total of 1113 messages from 14 participating physicians from 7 medical offices were analyzed. The length of questions and answers, and the time physicians spent answering the questions were recorded and analyzed. Results: Physicians spent an average of 2.3 minutes (median 2 minutes) answering questions from patients. The patients’ questions had an average length of 507.1 characters (95% CI 487.4–526.9, SD 336.2), while physicians’ answers averaged 119.9 characters (95% CI 189.8–210.0, SD 172.6). The results show that the influence of patient question length on time spent responding was negligible. For the shortest 25% of the questions the answer time was 2.1 minutes (95% CI 1.9–2.3), while it was 2.4 minutes (95% CI 2.2–2.7) for the longest 25%. Even extremely long questions had a minimal impact on the time spent answering them. A threefold increase in question length from patients resulted in only an 18% increase in physician response time. The study shows the potential clinical usefulness of electronic communication between patients and health care services by demonstrating the potential for saving time. URI: http://hdl.handle.net/10037/3861 File(s) in this item: 1
article.pdf (271.0Kb) -
Jorde, Rolf; Schirmer, Henrik; Wilsgaard, Tom; Joakimsen, Ragnar Martin; Mathiesen, Ellisiv B.; Njølstad, Inger; Løchen, Maja-Lisa; Figenschau, Yngve; Berg, Jens Petter; Svartberg, Johan; Grimnes, Guri (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Low serum 25(OH)D levels are associated with cardiovascular risk factors, and also predict future myocardial infarction (MI), type 2 diabetes (T2DM), cancer and all-cause mortality. Recently several single nucleotide polymorphisms (SNPs) associated with serum 25-hydroxyvitamin D (25(OH)D) level have been identified. If these relations are causal one would expect a similar association between these SNPs and health. DNA was prepared from subjects who participated in the fourth survey of the Tromsø Study in 1994–1995 and who were registered with the endpoints MI, T2DM, cancer or death as well as a randomly selected control group. The endpoint registers were complete up to 2007–2010. Genotyping was performed for 17 SNPs related to the serum 25(OH)D level. A total of 9528 subjects were selected for genetic analyses which were successfully performed for at least one SNP in 9471 subjects. Among these, 2025 were registered with MI, 1092 with T2DM, 2924 with cancer and 3828 had died. The mean differences in serum 25(OH)D levels between SNP genotypes with the lowest and highest serum 25(OH)D levels varied from 0.1 to 7.8 nmol/L. A genotype score based on weighted risk alleles regarding low serum 25(OH)D levels was established. There was no consistent association between the genotype score or individuals SNPs and MI, T2DM, cancer, mortality or risk factors for disease. However, for rs6013897 genotypes (located at the 24-hydroxylase gene (CYP24A1)) there was a significant association with breast cancer (P<0.05). Our results do not support nor exclude a causal relationship between serum 25(OH)D levels and MI, T2DM, cancer or mortality, and our observation on breast cancer needs confirmation. Further genetic studies are warranted, particularly in populations with vitamin D deficiency. URI: http://hdl.handle.net/10037/4936 File(s) in this item: 1
article.pdf (167.1Kb) -
Chrisanthar, Ranjan; Knappskog, Stian; Løkkevik, Erik; Anker, Gun Birgitta; Østenstad, Bjørn; Lundgren, Steinar; Risberg, Terje; Mjaaland, Ingvil; Skjønsberg, Gudbrand; Aas, Turid; Schlichting, Ellen; Fjøsne, Hans Erikssønn; Nysted, Arne; Lillehaug, Johan R.; Lønning, Per Eystein (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: TP53 mutations have been associated with resistance to anthracyclines but not to taxanes in breast cancer patients. The MDM2 promoter single nucleotide polymorphism (SNP) T309G increases MDM2 activity and may reduce wildtype p53 protein activity. Here, we explored the predictive and prognostic value of TP53 and CHEK2 mutation status together with MDM2 SNP309 genotype in stage III breast cancer patients receiving paclitaxel or epirubicin monotherapy. Each patient was randomly assigned to treatment with epirubicin 90 mg/m2 (n= 109) or paclitaxel 200 mg/m2 (n = 114) every 3rd week as monotherapy for 4–6 cycles. Patients obtaining a suboptimal response on first-line treatment requiring further chemotherapy received the opposite regimen. Time from last patient inclusion to follow-up censoring was 69 months. Each patient had snap-frozen tumor tissue specimens collected prior to commencing chemotherapy. While TP53 and CHEK2 mutations predicted resistance to epirubicin, MDM2 status did not. Neither TP53/ CHEK2 mutations nor MDM2 status was associated with paclitaxel response. Remarkably, TP53 mutations (p = 0.007) but also MDM2 309TG/GG genotype status (p = 0.012) were associated with a poor disease-specific survival among patients having paclitaxel but not patients having epirubicin first-line. The effect of MDM2 status was observed among individuals harbouring wild-type TP53 (p = 0.039) but not among individuals with TP53 mutated tumors (p.0.5). TP53 and CHEK2 mutations were associated with lack of response to epirubicin monotherapy. In contrast, TP53 mutations and MDM2 309G allele status conferred poor disease-specific survival among patients treated with primary paclitaxel but not epirubicin monotherapy. URI: http://hdl.handle.net/10037/3971 File(s) in this item: 1
article.pdf (593.3Kb) -
Murad, Mudhafar Karim; Larsen, Stig; Husum, Hans (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Background Blunt implementation of Western trauma system models is not feasible in low-resource communities with long prehospital transit times. The aims of the study were to evaluate to which extent a low-cost prehospital trauma system reduces trauma deaths where prehospital transit times are long, and to identify specific life support interventions that contributed to survival. Methods In the study period from 1997 to 2006, 2,788 patients injured by land mines, war, and traffic accidents were managed by a chain-of-survival trauma system where non-graduate paramedics were the key care providers. The study was conducted with a time-period cohort design. Results 37% of the study patients had serious injuries with Injury Severity Score ≥ 9. The mean prehospital transport time was 2.5 hours (95% CI 1.9 - 3.2). During the ten-year study period trauma mortality was reduced from 17% (95% CI 15 -19) to 4% (95% CI 3.5 - 5), survival especially improving in major trauma victims. In most patients with airway problems, in chest injured, and in patients with external hemorrhage, simple life support measures were sufficient to improve physiological severity indicators. Conclusion In case of long prehospital transit times simple life support measures by paramedics and lay first responders reduce trauma mortality in major injuries. Delegating life-saving skills to paramedics and lay people is a key factor for efficient prehospital trauma systems in low-resource communities. URI: http://hdl.handle.net/10037/4680 File(s) in this item: 1
article.pdf (1.096Mb) -
Augestad, Knut Magne; Lindsetmo, Rolv-Ole; Stulberg, J; Reynolds, H; Champagne, B; Leblanc, F; Heriot, AG; Senagore, A; Delaney, C (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: In a letter to the editor Dr. Hottenrott provides valuable comments on our survey describing international preoperative rectal cancer management. In our opinion, three key messages are derived from our survey: First, most surgeons agree to neoadjuvant treatment when there is an increased risk of finding histologically positive circumferential margins. In addition, we found more than 40 other indications for neoadjuvant treatment (see our Table 4). This emphasizes the need for an international agreement, as different indications for neoadjuvant treatment will select noncomparable groups of patients in outcome studies. Second, we have shown (see our Table 6) that multidisciplinary team (MDT) meetings significantly influence several important decisions in preoperative rectal cancer management. Interestingly, centers with regular MDT have a higher rate of using magnetic resonance imaging (MRI) (Odds Ratio [OR] = 3.62) and consider a threatened circumferential resection margin (CRM) as indication for neoadjuvant treatment (OR = 5.67). We believe that MDT improves preoperative management of rectal cancer by increasing adherence to national guidelines. Similar discussions in international rectal cancer societies are needed aiming towards an international consensus statement. Finally, our survey revealed sparse use (35% of all cases) of MRI. The goal for the radiologic examination in rectal cancer is to explore the tumor’s relation to nearby anatomical structures. This evaluation will conclude with TNM staging, important for chemoradiotheraphy, surgical treatment, and prognosis. Magnetic resonance imaging has a central role in this evaluation and should be the first choice radiologic modality. Not only is MRI crucial in detection of TNM stage but also plays a central role in determination of the tumor’s distance to the mesorectal fascia and the CRM. Magnetic resonance imaging has moderate sensitivity on T1 and T2 tumors, and should be supplemented with rectal ultrasound. URI: http://hdl.handle.net/10037/3918 File(s) in this item: 1
article.pdf (113.1Kb) -
Nieder, Carsten; Norum, Jan (Journal article; Tidsskriftartikkel; Peer reviewed, 30-Sep-2008)[+][-]
Abstract: Case presentation: This is an unusual case where a 49-year old female patient with known schizophrenia, paranoid type and a history of early-stage breast cancer, which was treated more than 6 years earlier, attempted suicide. Computed tomography and magnetic resonance imaging after this incident revealed the presence of multiple brain metastases as the first symptomatic site of recurrent cancer. Further staging lead to the diagnosis of lung, hilar and mediastinal lymph node metastases and histology confirmed estrogen receptor-positive metastatic cancer. Treatment consisted of whole-brain radiotherapy and letrozole. Twenty-one months later, the patient is in continued partial remission. URI: http://hdl.handle.net/10037/2141 File(s) in this item: 1
article.pdf (922.5Kb) -
Andersen, Sigve; Dønnem, Tom; Al-Shibli, Khalid Ibrahim; Al-Saad, Samer; Stenvold, Helge; Busund, Lill-Tove; Bremnes, Roy M. (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Angiopoietins and their receptor Tie-2 are, in concert with VEGF-A, key mediators in angiogenesis. This study evaluates the prognostic impact of all known human angiopoietins (Ang-1, Ang-2 and Ang-4) and their receptor Tie-2, as well as their relation to the prognostic expression of VEGF-A. 335 unselected stage I-IIIA NSCLC-patients were included and tissue samples of respective tumor cells and stroma were collected in tissue microarrays (TMAs). Immunohistochemistry (IHC) was used to semiquantitatively evaluate the expression of markers in duplicate tumor and stroma cores. In univariate analyses, low tumor cell expression of Ang-4 (P = 0.046) and low stromal expressions of Ang-4 (P = 0.009) and Ang-2 (P = 0.017) were individually associated with a poor survival. In the multivariate analysis, low stromal Ang-2 (HR 1.88; CI 95% 1.15-3.08) and Ang-4 (HR 1.47, CI 95% 1.02–2.11, P = 0.04) expressions were independently associated with a poor prognosis. In patients with high tumor cell expression of Ang-2, a concomitantly high tumor VEGF-A expression mediated a dramatic survival reduction (P,0.001). In the multivariate analysis of patients with high Ang-2 expression, high tumor VEGF-A expression appeared an independent poor prognosticator (HR 6.43; CI 95% 2.46–16.8; P,0.001). In tumor cells, only Ang-4 expression has prognostic impact in NSCLC. In tumor stroma, Ang-4 and Ang-2 are independently associated with survival. The prognostic impact of tumor cell VEGF-A in NSCLC appears strongly associated with a concomitantly high tumor cell expression of Ang-2. URI: http://hdl.handle.net/10037/3960 File(s) in this item: 1
article.pdf (2.080Mb) -
Smeland, Eivind; Kilvær, Thomas Karsten; Sørbye, Sveinung Wergeland; Valkov, Andrey Yurjevich; Andersen, Sigve; Bremnes, Roy M.; Busund, Lill-Tove; Dønnem, Tom (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: We aimed to explore the prognostic impact of the hypoxia-induced factors (HIFαs) 1 and 2, the metabolic HIFregulated glucose transporter GLUT-1, and carbonic anhydrase IX (CAIX) in non-gastrointestinal stromal tumor soft tissue sarcomas (non-GIST STS). Methods. Duplicate cores with viable tumor tissue from206 patients with non-GIST STS were obtained and tissue microarrays were constructed. Immunohistochemistry (IHC) was used to evaluate expression of hypoxic markers. Results. In univariate analyses, GLUT-1 (P < 0.001) and HIF-2α (P = 0.032) expression correlated significantly with a poor disease-specific survival (DSS). In the multivariate analysis, however, only high expression of GLUT-1 (HR 1.7, CI 95% 1.1–2.7, P = 0.021) was a significant independent prognostic indicator of poor DSS. Conclusion. GLUT-1 is a significant independent negative prognostic factor in non-GIST STS. URI: http://hdl.handle.net/10037/4888 File(s) in this item: 1
article.pdf (7.322Mb) -
Dønnem, Tom; Al-Shibli, Khalid; Al-Saad, Samer; Busund, Lill-Tove; Bremnes, Roy M. (Tidsskriftartikkel; Peer reviewed; Journal article, May-2009)[+][-]
Abstract: Purpose: Fibroblast growth factor 2 (FGF2; basic fibroblast growth factor, b-FGF) and its main receptor FGFR-1 are important in both hemangiogenesis and lymphangiogenesis. Murine studies have indicated a close interplay between both FGF2 and platelet-derived growth factor –B (PDGF-B) as well as FGF2 and vascular endothelial growth factor -3 (VEGFR-3). This study investigates the prognostic impact of FGF2 and FGFR-1 in tumor cells and tumor stroma of resected non-small cell lung carcinomas (NSCLC) and explores the importance of their co-expression with VEGFR-3 or PDGF-B.
Methods: Tumor tissue samples from 335 resected patients with stage I to IIIA NSCLC were obtained and tissue microarrays were constructed from duplicate cores of tumor cells and tumor-related stroma from each specimen. Immunohistochemistry was used to evaluate the expression of the molecular markers FGF2, FGFR-1, VEGFR-3 and PDGF-B.
Results: In univariate analyses, high tumor cell FGF2 expression (P = 0.015) was a negative prognostic indicator for disease-specific survival (DSS). In tumor stroma, high FGF2 (P = 0.024) expression correlated with good prognosis. In multivariate analyses, high expression of FGF2 in tumor cells (P = 0.038) was an independent negative prognostic factor whereas increased FGF2 in stroma (P = 0.015) was a positive prognosticator. Tumor cell coexpressions of FGF2/VEGFR-3 (P < 0.001) and GFR-1/PDGF-B (P = 0.002) were significant indicators of poor prognosis.
Conclusions: Expression of FGF2 in tumor cells is an independent negative prognostic factor, and the co-expressions of FGF2/VEGFR-3 and FGFR-1/PDGF-B are strongly associated with poor survival in NSCLC patients.Description: This is the accepted version of the article. Published version available at http://dx.doi.org/10.1097/JTO.0b013e31819f2e38, © Lippincott W&W, reprinted with permission.
This article is part of Tom Dønnem's PhD thesis, which is available in Munin: http://hdl.handle.net/10037/1879URI: http://hdl.handle.net/10037/2448 File(s) in this item: 1
article.pdf (1.425Mb) -
Dønnem, Tom; Eklo, Katrine; Berg, Thomas; Sørbye, Sveinung Wergeland; Lønvik, Kenneth; Al-Saad, Samer; Al-Shibli, Khalid Ibrahim; Andersen, Sigve; Stenvold, Helge; Bremnes, Roy M.; Busund, Lill-Tove (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: In recent years, microRNAs (miRNAs) have been found to play an essential role in tumor development. In lung tumorigenesis, targets and pathways of miRNAs are being revealed, and further translational research in this field is warranted. MiR-155 is one of the miRNAs most consistently involved in various neoplastic diseases. We aimed to investigate the prognostic impact of the multifunctional miR-155 in non-small cell lung cancer (NSCLC) patients. Tumor tissue samples from 335 resected stage I to IIIA NSCLC patients were obtained and tissue microarrays (TMAs) were constructed with four cores from each tumor specimen. In situ hybridization (ISH) was used to evaluate the expression of miR-155. There were 191 squamous cell carcinomas (SCCs), 95 adenocarcinomas (ACs), 31 large cell carcinomas and 18 bronchioalveolar carcinomas. MiR-155 expression did not have a significant prognostic impact in the total cohort (P = 0.43). In ACs, high miR-155 expression tended to a significant negative prognostic effect on survival in univariate analysis (P = 0.086) and was an independent prognostic factor in multivariate analysis (HR 1.87, CI 95% 1.01 - 3.48, P = 0.047). In SCC patients with lymph node metastasis, however, miR-155 had a positive prognostic impact on survival in univariate (P = 0.034) as well as in multivariate (HR 0.45, CI 95% 0.21-0.96, P = 0.039) analysis. The prognostic impact of miR-155 depends on histological subtype and nodal status in NSCLC. URI: http://hdl.handle.net/10037/3864 File(s) in this item: 1
article.pdf (516.2Kb) -
Sørbye, Sveinung Wergeland; Kilvær, Thomas Karsten; Valkov, Andrey Yurjevich; Dønnem, Tom; Smeland, Eivind; Al-Shabli, Khalid; Bremnes, Roy M.; Busund, Lill-Tove (Journal article; Tidsskriftartikkel; Peer reviewed, 2013)[+][-]
Abstract: BACKGROUND: S-phase kinase-associated protein 2 (Skp2) is a member of mammalian F-box proteins. The purpose of this study is to clarify the prognostic significance of expression of Skp2 related to gender, estrogen receptor (ER) and progesterone receptor (PGR) in soft tissue sarcomas (STS). Optimized treatment of STS requires better identification of high-risk patients who will benefit from adjuvant therapy. Skp2 has been demonstrated to display an oncogenic function since its overexpression has been observed in many human cancers. The prognostic significance of Skp2 related to ER and PGR in STS has not been sufficiently investigated. METHODS: Tissue microarrays from 193 STS patients were constructed from duplicate cores of viable and representative neoplastic tumor areas. Immunohistochemistry was used to evaluate the expression of Skp2, ER and PGR. RESULTS: In univariate analyses, high tumor expression of Skp2 correlated (p = 0.050) with reduced disease-specific survival (DSS). In subgroup analyses expression of PGR in males (p = 0.010) and in patients older than 60 years (p = 0.043) were negative prognostic factors for DSS. Expression of ER in females was a positive prognostic factor for DSS (p = 0.041). In co-expression analyses in the whole cohort, low expression of Skp2 in combination with low expression of ER was positive for DSS (p = 0.049). In females high expression of Skp2 in combination with low expression of ER was a negative prognosticator (p = 0.021). In the multivariate analyses, age (p = 0.012), malignancy grade (p < 0.001), wide resection margins (P = 0.010), ER negative / PGR positive co-expression profile (p = 0.002) and ER positive / PGR negative co-expression profile (p = 0.015) were independent negative prognostic factors for DSS. In females expression of Skp2 (p = 0.006) was associated with shorter DSS. CONCLUSIONS: We found diverse prognostic impacts of expression of Skp2, ER, PGR and DSS in male and female patients with STS. In men, but not women, ER positive / PGR negative co-expression profile was an independent negative prognostic factor for DSS. In women, but not men, high expression of Skp2 was associated with reduced DSS. URI: http://hdl.handle.net/10037/5049 File(s) in this item: 1
article.pdf (1.325Mb) -
Nieder, Carsten; Mehta, Minesh P. (Journal article; Peer reviewed; Tidsskriftartikkel, 04-Mar-2009)[+][-]
Abstract: Background: This review addresses the strengths and weaknesses of 6 different prognostic indices, published since the Radiation Therapy Oncology Group (RTOG) developed and validated the widely used 3-tiered prognostic index known as recursive partitioning analysis (RPA) classes, i.e. between 1997 and 2008. In addition, other analyses of prognostic factors in groups of patients, which typically are underrepresented in large trials or databases, published in the same time period are reviewed.
Methods: Based on a systematic literature search, studies with more than 20 patients were included. The methods and results of prognostic factor analyses were extracted and compared. The authors discuss why current data suggest a need for a more refined index than RPA.
Results: So far, none of the indices has been derived from analyses of all potential prognostic factors. The 3 most recently published indices, including the RTOG's graded prognostic assessment (GPA), all expanded from the primary 3-tiered RPA system to a 4-tiered system. The authors' own data confirm the results of the RTOG GPA analysis and support further evaluation of this tool.
Conclusion: This review provides a basis for further refinement of the current prognostic indices by identifying open questions regarding, e.g., performance of the ideal index, evaluation of new candidate parameters, and separate analyses for different cancer types. Unusual primary tumors and their potential differences in biology or unique treatment approaches are not well represented in large pooled analyses.URI: http://hdl.handle.net/10037/2189 File(s) in this item: 1
article.pdf (316.9Kb) -
Marienhagen, Kirsten; Nieder, Carsten; Astner, Sabrina T.; Molls, Michael (Journal article; Tidsskriftartikkel; Peer reviewed, 07-Apr-2009)[+][-]
Abstract: Background: Prognostic scores might be useful tools both in clinical practice and clinical trials, where they can be used as stratification parameter. The available scores for patients with brain metastases have never been tested specifically in patients with primary breast cancer. It is therefore unknown which score is most appropriate for these patients.
Methods: Five previously published prognostic scores were evaluated in a group of 83 patients with brain metastases from breast cancer. All patients had been treated with whole-brain radiotherapy with or without radiosurgery or surgical resection. In addition, it was tested whether the parameters that form the basis of these scores actually have a prognostic impact in this biologically distinct group of brain metastases patients.
Results: The scores that performed best were the recursive partitioning analysis (RPA) classes and the score index for radiosurgery (SIR). However, disagreement between the parameters that form the basis of these scores and those that determine survival in the present group of patients and many reported data from the literature on brain metastases from breast cancer was found. With the four statistically significant prognostic factors identified here, a 3-tiered score can be created that performs slightly better than RPA and SIR. In addition, a 4-tiered score is also possible, which performs better than the three previous 4-tiered scores, incl. graded prognostic assessment (GPA) score and basic score for brain metastases (BSBM).
Conclusion: A variety of prognostic models describe the survival of patients with brain metastases from breast cancer to a more or less satisfactory degree. However, the standard brain metastases scores might not fully appreciate the unique biology and time course of this disease, e.g., compared to lung cancer. It appears possible that inclusion of emerging prognostic factors will improve the results and allow for development and validation of a consensus score for broad clinical application. The model that is based on the authors own patient group, which is not large enough to fully evaluate a large number of potential prognostic factors, is meant to illustrate this point rather than to provide the definitive score.URI: http://hdl.handle.net/10037/2190 File(s) in this item: 1
article.pdf (259.0Kb)
Search Munin
Browse
-
All of Munin
-
This Collection
Help
Munin is powered by DSpace 1.8.2
The University Library of Tromsø, N-9037 Tromsø
Tel: +47 77 64 40 00, E-mail: munin@ub.uit.no