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Performance of a Score for Advanced Proximal Colorectal Neoplasia in a Chinese Population
January 2017 METHODS: A literature search was performed through PubMed and Cochrane Library. Studies were screened and met accordingly based on inclusion and exclusion criteria. A total of eight studies were selected and critically appraised for its validity, importance and applicability. RESULTS: All studies showed that the concomitant use of vasoconstrictor agent was able to significantly enhance the therapeutic effects of albumin and increases renal function. CONCLUSION: Terlipressin may improve renal function in patients with type 1 HRS. Whether the evidence is strong enough to support the intervention for clinical practice could be debated due to the results of the trial sequential analyses. However, the outcome measures assessed are objective, which reduces the risk of bias. Keywords: type 1 hepatorenal syndrome, terlipressin, renal
function References
1. Gluud LL, Christensen K, Christensen E, A K. Systematic review of randomized trals on vasoconstrictor drugs for hepatorenal syndrome. Hepatology 2010;51:576–584. 2. Arroyo V, Fernandez J, P G. Pathogenesis and treatment of hepatorenal syndrome. Semin Liver Dis 2008;28:81–95. 3. Martin-Llahi M, Pepin MN, Guevara M, Diaz F, A T. Terlipressin and albumin vs albumin in patients with cirrhosis and hepatorenal syndrome: a randomized study. Gastroenterology 2008;134:1352–1359. Conflicts of interest: The authors disclose no conflicts.
Performance of a Score for Advanced Proximal Colorectal Neoplasia in a Chinese Population Jason Liwen Huang,1 Ping Chen,2 Xiaoqin Yuan,2 Yunlin Wu,2 Harry Haoxiang Wang,3 and Martin Chisang Wong1 1
JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China, 2Ruijin Hospital North, Shanghai Jiaotong University, Shanghai, China, and 3School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China BACKGROUND: Subjects at higher risk for advanced prox-
imal neoplasia (APN) are more suited to receive colonoscopy as a primary colorectal cancer screening tool. A 7-point index based on age, gender, and distal findings at sigmoidoscopy has been proposed to predict the risk for APN.1 Despite good internal validation, few studies have been performed to externally validate the index. We aim to evaluate its external validity and discriminatory capability in Chinese screening participants. METHODS: Age, gender, and colonoscopic findings were prospectively collected in a hospital-based endoscopy unit in Shanghai, China (2013-2015). The cumulative
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score from each subject derived from the index was categorized into low, intermediate, or high risk, and rates of APN were assessed accordingly. We used the area under curve (AUC) to evaluate index performance and binary regression models to assess the predictive value for APN. RESULTS: Among 5833 subjects, 151 (2.6%) had APNs. Rates of APN in low, intermediate and high risk subgroup were 0.6%, 1.6% and 6.3%, respectively (p<0.001). The model’s AUC was 0.724 (95% CI 0.685-0.763). Age, gender and distal finding were all independent predictors of APN. When compared with the subjects in the low risk group, those in the intermediate (adjusted odds ratio [aOR] ¼2.52, 95% CI 1.29-4.93) and high risk (aOR¼10.49, 95% CI 5.61-19.62) group were significantly more likely to have APN detected. CONCLUSION: The model based on age, gender and distal finding has good performance to predict APN in a Chinese population. The current findings supported its use to tailor endoscopy-based screening (249 words) Reference 1. Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD,
Ransohoff DF. Using risk for advanced proximal colonic neoplasia to tailor endoscopic screening for colorectal cancer. Ann Intern Med 2003;139: 959–965. Conflicts of interest: The authors disclose no conflicts.
Association Mining of Mutational Landscape in Four Clinical Stages across 11 Cancer Types Wangxiong Hu and Shu Zheng Cancer Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China BACKGROUND: Cancer is driven largely by somatic ‘driver mutations’ that accumulate in the genome. So far, hundreds of cancer driver genes have been annotated in Catalogue of Somatic Mutations in Cancer (COSMIC), although insightful, underlying interaction of these driver genes in specific cancer genome remains unclear. METHODS: Here we used Apriori algorithm to find frequent mutational gene sets (FMGSs) with point mutations and small insertions/deletions from 4,904 tumors across 11 cancer types as part of the TCGA (The Cancer Genome Atlas) Pan-Cancer effort and then mine the hidden association rules (ARs) within these FMGSs. RESULTS AND CONCLUSION: We found that well-known cancer driver genes such as APC, PIK3CA, PTEN, and TP53 were often co-occurred with other driver genes and FMGSs size peak at an itemset size of 4w5 genes. Moreover, the number and constitution of FMGS and ARs differed greatly among different cancers and stages. By extension, endocrine-related cancers such as breast carcinoma, ovarian cystadenocarcinoma, and thyroid carcinoma were bare of FMGS and ARs, while cancers contact directly with external environments such as
function References
1. Gluud LL, Christensen K, Christensen E, A K. Systematic review of randomized trals on vasoconstrictor drugs for hepatorenal syndrome. Hepatology 2010;51:576–584. 2. Arroyo V, Fernandez J, P G. Pathogenesis and treatment of hepatorenal syndrome. Semin Liver Dis 2008;28:81–95. 3. Martin-Llahi M, Pepin MN, Guevara M, Diaz F, A T. Terlipressin and albumin vs albumin in patients with cirrhosis and hepatorenal syndrome: a randomized study. Gastroenterology 2008;134:1352–1359. Conflicts of interest: The authors disclose no conflicts.
Performance of a Score for Advanced Proximal Colorectal Neoplasia in a Chinese Population Jason Liwen Huang,1 Ping Chen,2 Xiaoqin Yuan,2 Yunlin Wu,2 Harry Haoxiang Wang,3 and Martin Chisang Wong1 1
JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China, 2Ruijin Hospital North, Shanghai Jiaotong University, Shanghai, China, and 3School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China BACKGROUND: Subjects at higher risk for advanced prox-
imal neoplasia (APN) are more suited to receive colonoscopy as a primary colorectal cancer screening tool. A 7-point index based on age, gender, and distal findings at sigmoidoscopy has been proposed to predict the risk for APN.1 Despite good internal validation, few studies have been performed to externally validate the index. We aim to evaluate its external validity and discriminatory capability in Chinese screening participants. METHODS: Age, gender, and colonoscopic findings were prospectively collected in a hospital-based endoscopy unit in Shanghai, China (2013-2015). The cumulative
Abstracts
e33
score from each subject derived from the index was categorized into low, intermediate, or high risk, and rates of APN were assessed accordingly. We used the area under curve (AUC) to evaluate index performance and binary regression models to assess the predictive value for APN. RESULTS: Among 5833 subjects, 151 (2.6%) had APNs. Rates of APN in low, intermediate and high risk subgroup were 0.6%, 1.6% and 6.3%, respectively (p<0.001). The model’s AUC was 0.724 (95% CI 0.685-0.763). Age, gender and distal finding were all independent predictors of APN. When compared with the subjects in the low risk group, those in the intermediate (adjusted odds ratio [aOR] ¼2.52, 95% CI 1.29-4.93) and high risk (aOR¼10.49, 95% CI 5.61-19.62) group were significantly more likely to have APN detected. CONCLUSION: The model based on age, gender and distal finding has good performance to predict APN in a Chinese population. The current findings supported its use to tailor endoscopy-based screening (249 words) Reference 1. Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD,
Ransohoff DF. Using risk for advanced proximal colonic neoplasia to tailor endoscopic screening for colorectal cancer. Ann Intern Med 2003;139: 959–965. Conflicts of interest: The authors disclose no conflicts.
Association Mining of Mutational Landscape in Four Clinical Stages across 11 Cancer Types Wangxiong Hu and Shu Zheng Cancer Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China BACKGROUND: Cancer is driven largely by somatic ‘driver mutations’ that accumulate in the genome. So far, hundreds of cancer driver genes have been annotated in Catalogue of Somatic Mutations in Cancer (COSMIC), although insightful, underlying interaction of these driver genes in specific cancer genome remains unclear. METHODS: Here we used Apriori algorithm to find frequent mutational gene sets (FMGSs) with point mutations and small insertions/deletions from 4,904 tumors across 11 cancer types as part of the TCGA (The Cancer Genome Atlas) Pan-Cancer effort and then mine the hidden association rules (ARs) within these FMGSs. RESULTS AND CONCLUSION: We found that well-known cancer driver genes such as APC, PIK3CA, PTEN, and TP53 were often co-occurred with other driver genes and FMGSs size peak at an itemset size of 4w5 genes. Moreover, the number and constitution of FMGS and ARs differed greatly among different cancers and stages. By extension, endocrine-related cancers such as breast carcinoma, ovarian cystadenocarcinoma, and thyroid carcinoma were bare of FMGS and ARs, while cancers contact directly with external environments such as