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We aimed to develop and validate a predictive model to evaluate in-hospital mortality risk in HIV/AIDS patients with PCP in China. 1001 HIV/AIDS patients with PCP admitted in the Beijing Ditan hospital from August 2009 to January 2018 were included in this study. Multivariate Cox proportional hazard model was used to identify independent risk factors of death, and a predictive model was devised based on risk factors. The overall in-hospital mortality was 17.3%. The patients were randomly assigned into derivation cohort (801cases) and validation cohort (200 cases) in 8:2 ratio, respectively, in which in derivation cohort we found that 7 predictors, including LDH >350U/L, HR>130 times/min, room air PaO2 <70mmHg, later admission to ICU, Anemia (HGB≤90g/L), CD4<50cells/ul, and development of a pneumothorax, were associated with poor prognosis in HIV/AIDS patients with PCP and were included in the predictive model. The model had excellent discrimination with AUC of 0.904 and 0.921 in derivation and validation cohort, respectively. The predicted scores were divided into two groups to assess the in-hospital mortality risk: low-risk group (0-11 points with mortality with 2.15-12.77%) and high-risk group (12-21 points with mortality with 38.78%-81.63%). The cumulative mortality rate also indicated significant difference between two groups with Kaplan-Meier curve (p<0.001). A predictive model to evaluate mortality in HIV/AIDS patients with PCP was constructed based on routine laboratory and clinical parameters, which may be a simple tool for physicians to assess the prognosis in HIV/AIDS patients with PCP in China. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the relationships between the clinicopathologic features and the expression of GCS in bladder cancer. Methods and materials: Using immunohistochemistry and Western blotting method, 75 bladder cancer specimens were tested for expression of GCS. The correlation of GCS with clinicopathologic features of the patients was analyzed in combination with clinical data. Statistics analyses were done with SPSS 13.0 software, χ2 test, Fisher''s exact test, Kaplan-Meier method, Log-rank test. Results: High and low level expression of GCS explored by immunohistochemistry were 61.3 (46/75) and 39.6 (29/75), respectively. The high expression group (n = 46) showed a significant correlation with high histologic grade (P = 0.021) and tended to show (P = 0.045) that up-expression of GCS was positive related to BNs with lymph node metastasis among the various clinicopathologic characteristics. The overall 5-year survival and disease-free survival rates were 39.5% and 18.4%, respectively. Mean overall survival time was 60.3 months for the low expression group and 45.1 months for the high expression group. Mean disease-free survival was 36.2 months for the low-expression group and 27.3 months for the high-expression group. Conclusion: Our study suggested that up-regulation of GCS might make an aggressive choice of surgical therapy. A high expression of GCS seemed to be an indicator of poor prognosis. [Copyright &y& Elsevier]

Background: The lymphocytes played an important role in the natural history of cancer. The aim of this study was to explore the prognostic value of lymphocyte count and percentage for survival in advanced cancer patients receiving palliative care.Methods: A retrospective review of clinicopathological data from 378 consecutive advanced cancer patients and 106 extended follow-up patients treated with palliative care was conducted. Kaplan-Meier curves and multivariate cox regression analyses were used to evaluate the relationships of peripheral lymphocyte count (LC) and lymphocyte to white blood cell ratio (LWR) with overall survival (OS).Results: The median values for pretreatment LC and LWR were 1.1 (IQR, 0.8 ~ 1.5 × 109/L) and 0.138 (IQR, 0.086 ~ 0.208). The median survival times across LWR quartiles were 19, 47, 79, and 101 days (P < 0.001). Multivariate analysis indicated that patients in the highest quartiles of LC and LWR had an HR of 1.082 (95% CI 0.777 ~ 1.506, P = 0.642) and 0.466 (95% CI 0.328 ~ 0.661, P < 0.001), respectively, compared with patients in the lowest quartiles. Furthermore, only the dynamic changes of LWR were confirmed as an independent prognostic factor for overall survival during the follow-up (HR = 0.396, 95% CI 0.243 ~ 0.668; P = 0.001), as were primary tumor site and ECOG. No effect was observed for the dynamic changes of LC.Conclusions: Our findings demonstrate that measurement of the dynamic changes of LWR prior to treatment and during follow-up may represent a simple and new powerful prognostic factor for patients with advanced cancer, unlike measurement of LC. As a bedside marker of immune status, the prognostic role of LWR should be further evaluated in prospective studies. [ABSTRACT FROM AUTHOR]

Objectives: Metaplastic breast carcinomas (MBCs) are rare, aggressive cancers lacking targeted therapy. Here, we review the clinicopathologic features, treatment, and outcomes of patients with MBC treated at our institution.Methods: We searched clinical and pathology databases for patients with histologically confirmed MBC from 1999 to 2012. We estimated survival probabilities using the Kaplan-Meier method and evaluated prognostic factors using Cox regression.Results: Forty-five cases were identified, including chondroid (24%), spindled (20%), sarcomatoid (16%), squamous (11%), and mixed (29%) histologic subtypes. Median tumor size was 3 cm, with 86% grade III and 69% triple-negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. Most had negative lymph nodes, and two patients had metastases at diagnosis. Six patients received neoadjuvant therapy, with one pathologic complete response. All patients underwent surgery, 60% received adjuvant radiation, and 58% had adjuvant chemotherapy. Five-year recurrence-free survival was 64%; 5-year overall survival was 69%. Tumor size, history of breast cancer, and mixed histology were associated with inferior outcomes.Conclusions: We report one of the largest single-institution series of patients with MBC. MBC is associated with a poor prognosis, despite low nodal involvement. Most patients in this series had high-grade, triple-negative tumors and were treated with optimal therapy. [ABSTRACT FROM AUTHOR]