Predictors Of Progression In Patients Research Articles

Current Predictors of Atrial Fibrillation Progression

Aim. To identify predictors of progression of atrial fibrillation (AF) in patients with hypertension (HT), coronary heart disease (CHD) and chronic heart failure (CHF) with recurrent AF. Material and methods . The study included 31 2 patients with recurrent AF. The patients were divided into 3 groups according to a leading underlying condition: essential HT (n=1 36), CHD (n=11 2), and CHF with III-IV functional class by NYHA (n=64). The average follow-up duration was 60±3 months. Progression of AF was defined as development of long-standing persistent or permanent AF. Results. All three groups of patients with recurrent AF revealed progression of the arrhythmia from paroxysmal or persistent to a sustained permanent form during the 5-year prospective follow-up. The rate of AF progression in the patients with CHF was significantly higher and accounted for 59% as compared to 46% in the patients with hypertension (p=0.002) and 51% in the patients with CHD (p=0.008). AF progression in patients with HT correlated significantly with left ventricular (LV) hypertrophy (odds ratio [OR] 1.25; 95% confidence interval [95%CI] 1.03-1.52) and increased arterial wall stiffness (OR 2.3; 95%CI 1.95-2.65). The independent predictors of arrhythmia progression in patients with CHD were a history of myocardial infarction (OR 1.23; 95%CI 0.9-1.5), irreversible LV wall motion abnormalities (OR 1.41; 95%CI 1.1-1.7), and increased plasma level of N-terminal pro-A-type natriuretic peptide (Nt-proANP; OR 1.16; 95%CI 0.8-1.4). Reduction in LV ejection fraction below 40% (OR 0.84; 95%CI 0.7-0.89) and increased plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP; OR 2.3; 95%CI 1.93-2.67) were independent predictors of AF progression from persistent to permanent form in the patients with systolic heart failure. Conclusion. Progression of AF is related to the underlying cardiovascular disease. The early vascular aging syndrome and LV hypertrophy are the main factors of AF progression in patients with HT. Previous myocardial infarction with irreversible hypokinesia is associated with AF progression in patients with CHD. Reduced LV ejection fraction and increased plasma BNP predict AF progression in patients with CHF.

Abstract P4-08-08: Genomic progression, detected by circulating tumor DNA (ctDNA) sequencing, as an early predictor of disease progression in metastatic breast cancer (MBC)

Abstract Background: The availability of multiple therapies has transformed the landscape of MBC, but also brought the challenge of selecting the right therapy for an individual patient. Furthermore, in patients with Hormone Receptor positive (HR+) breast cancer who have bone metastases only it may be difficult to assess effectiveness of therapy via imaging. Peripheral ctDNA detection and analysis by next-generation sequencing (NGS) has gained popularity in cancer diagnosis and therapeutics due to its relative noninvasiveness, ease of use, and high sensitivity. Here, we explore the utility of ctDNA change as a predictor for disease progression in MBC. We hypothesized that genomic progression is a harbinger of subsequent radiologic progression in patients with MBC. Methods: We analyzed change from pre-treatment (baseline) to on-treatment ctDNA mutant allele fraction (MAF) among patients with MBC. Patients receiving standard-of-care therapies or investigational agents on clinical trials at our institution were included. All patients were followed from the date of baseline test until death or data cutoff (6/20/2018). All peripheral blood specimens were collected and analyzed between 1/7/2016 and 3/1/2018 via NGS (Guardant360®). Peripheral blood specimens were sequenced prior to initiation of a new therapeutic regimen (baseline) and subsequently at least once while on-treatment, on average 4-12 weeks later. All patients had a follow-up CT scan of chest, abdomen and pelvis 2-4 weeks after the on-treatment NGS. A priori, we defined genomic progression as increase in ctDNA total MAF of at least 20% from baseline. We utilized Cox regression analysis to identify whether genomic progression was a predictor of radiologic progression, adjusting for common prognostic variables. Results: All patients (N= 77) were female, predominantly White (83.1%), and median age was 57 (range 32 to 77). Fifty one out of 77 patients (66.2%) were ER+, 5 HER2+, and 9 had triple negative breast cancer. The median MAF at baseline was 2.2% (range 0% - 61.7%). Common genomic alterations in ctDNA included PIK3CA, TP53, ESR1, AKT1, NF1. 27 out of 77 (35%) patients showed disease progression on the first subsequent CT scan, while 59 out of 77 (76.6%) progressed during the follow up time. We found that an increase in ctDNA MAF of at least 20% was a strong predictor of disease progression (HR =2.46, CI [1.14-5.32], p=0.02), compared to those who had a MAF increase of less than 20% or a decrease in total MAF. In multi-variable analysis, adjusting for age, number of prior therapies, type of therapy, and visceral metastases, increase in ctDNA remained a significant predictor for subsequent disease progression (HR =3.84, CI [1.63-9.07], p=0.002). Subset results in patients with bone metastases only, and relative comparison of ctDNA with standard tumor markers will be presented at the meeting. Conclusions: Genomic progression, identified by an increase in ctDNA MAF, is potentially an early predictor of subsequent disease progression in patients with MBC. Further research is needed to prospectively evaluate the clinical utility of ctDNA change as a surrogate marker in guiding treatment decision-making for patients with MBC. Citation Format: Velimirovic M, Juric D, Niemierko A, Spring LM, Vidula N, Malvarosa G, Yuen M, Moy B, Isakoff SJ, Ellisen LW, Bardia A. Genomic progression, detected by circulating tumor DNA (ctDNA) sequencing, as an early predictor of disease progression in metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-08.

ATF6α downregulation of PPARα promotes lipotoxicity-induced tubulointerstitial fibrosis

Tubulointerstitial fibrosis is a strong predictor of progression in patients with chronic kidney disease, and is often accompanied by lipid accumulation in renal tubules. However, the molecular mechanisms modulating the relationship between lipotoxicity and tubulointerstitial fibrosis remain obscure. ATF6α, a transcription factor of the unfolded protein response, is reported to be an upstream regulator of fatty acid metabolism. Owing to their high energy demand, proximal tubular cells (PTCs) use fatty acids as their main energy source. We therefore hypothesized that ATF6α regulates PTC fatty acid metabolism, contributing to lipotoxicity-induced tubulointerstitial fibrosis. Overexpression of activated ATF6α transcriptionally downregulated peroxisome proliferator-activated receptor-α (PPARα), the master regulator of lipid metabolism, leading to reduced activity of fatty acid β-oxidation and cytosolic accumulation of lipid droplets in a human PTC line (HK-2). ATF6α-induced lipid accumulation caused mitochondrial dysfunction, enhanced apoptosis, and increased expression of connective tissue growth factor (CTGF), as well as reduced cell viability. Atf6α-/- mice had sustained expression of PPARα and less tubular lipid accumulation following unilateral ischemia-reperfusion injury (uIRI), resulting in the amelioration of apoptosis; reduced expression of CTGF, α-smooth muscle actin, and collagen I; and less tubulointerstitial fibrosis. Administration of fenofibrate, a PPARα agonist, reduced lipid accumulation and tubulointerstitial fibrosis in the uIRI model. Taken together, these findings suggest that ATF6α deranges fatty acid metabolism in PTCs, which leads to lipotoxicity-mediated apoptosis and CTGF upregulation, both of which promote tubulointerstitial fibrosis.

Preoperative neutrophil to lymphocyte ratio can improve disease progression prediction of non-muscle invasive bladder cancer

The purpose of this study was prospectively evaluate the ability of Neutrophil-to-Lymphocyte ratio (NLR) to predict disease progression in patients with non-muscle invasive bladder cancer (NMIBC). This is a continuation of our previous retrospective study that indicated the significance of NLR $>$ 2.5 criterion as a predictor of progression in patients with NMIBC. Since December 2013, all patients admitted to Bnai-Zion department for TUR-BT and agreed to participate in the study, had blood analyses for cell count and differential 24hr prior to surgery. Patients with pathological NMIBC were followed prospectively for disease progression. The end-point of the follow up was either a disease progression or the termination of the study. Kaplan-Meier curves and Cox regression were performed to assess the predictive ability of NLR $>$ 2.5 for disease progression. Our results demonstrate a significant difference ($p = $ 0.02) in mean progression-free survival - (35.9 months vs 41.1 months) in the whole cohort Kaplan-Meier survival plot factored by NLR $>$ 2.5. Mean progression-free survival of NLR $>$ 2.5 stratified by stage, grade and treatment (sub-group analysis), showed statistical significance ($p =$ 0.035) for those treated with intra-vesical instillation, and demonstrated a persistent trend for the rest of the stratifications - revealing that the NLR $>$ 2.5 groups always fared worse than the NLR $<$ 2.5 groups. In a univariate analysis, whole cohort Cox regression analysis for disease progression, NLR $>$ 2.5 was found significant ($p =$ 0.05; HR 7.8; CI 1-61), indicating that the probability of progression is increased at least 7-fold for a person with a NLR $>$ 2.5 compared with those with NLR $<$ 2.5. In conclusion, NLR $>$ 2.5 was found to be a significant predictor of disease progression and demonstrated high hazard ratio and worse progression-free survival in patients with NMIBC, especially in those treated with intra-vesical instillation. We propose to consider the incorporation of NLR $>$ 2.5 in the next revisions of the European Organization for Research and Treatment of Cancer (EORTC) scores, given more widely available evidence.

P774Biohumoral predictors of coronary atherosclerosis progression in patients with suspected coronary artery disease from the SMARTool Study

P774Biohumoral predictors of coronary atherosclerosis progression in patients with suspected coronary artery disease from the SMARTool Study

Risk stratification of smoldering multiple myeloma incorporating revised IMWG diagnostic criteria

In 2014, the International Myeloma Working Group reclassified patients with smoldering multiple myeloma (SMM) and bone marrow-plasma cell percentage (BMPC%) ≥ 60%, or serum free light chain ratio (FLCr) ≥ 100 or >1 focal lesion on magnetic resonance imaging as multiple myeloma (MM). Predictors of progression in patients currently classified as SMM are not known. We identified 421 patients with SMM, diagnosed between 2003 and 2015. The median time to progression (TTP) was 57 months (CI, 45–72). BMPC% > 20% [hazard ratio (HR): 2.28 (CI, 1.63–3.20); p < 0.0001]; M-protein > 2g/dL [HR: 1.56 (CI, 1.11–2.20); p = 0.01], and FLCr > 20 [HR: 2.13 (CI, 1.55–2.93); p < 0.0001] independently predicted shorter TTP in multivariate analysis. Age and immunoparesis were not significant. We stratified patients into three groups: low risk (none of the three risk factors; n = 143); intermediate risk (one of the three risk factors; n = 121); and high risk (≥2 of the three risk factors; n = 153). The median TTP for low-, intermediate-, and high-risk groups were 110, 68, and 29 months, respectively (p < 0.0001). BMPC% > 20%, M-protein > 2 g/dL, and FLCr > 20 at diagnosis can be used to risk stratify patients with SMM. Patients with high-risk SMM need close follow-up and are candidates for clinical trials aiming to prevent progression.

Predictors of disease progression in smoldering Waldenström macroglobulinemia.

7571Background: There are limited data on predictors of disease progression in patients (pts) with smoldering Waldenstrom Macroglobulinemia (SWM). We aim to address this issue in a large cohort of ...

Tu1122 - Early Histological Predictors of Progression in Patients with Barrett's Esophagus Related Low Grade Dysplasia

Tu1122 - Early Histological Predictors of Progression in Patients with Barrett's Esophagus Related Low Grade Dysplasia

Prognostic value of metabolic variables of [18F]FDG PET/CT in surgically resected stage I lung adenocarcinoma.

The objective of this study was to assess the prognostic value of metabolic tumor burden measured by positron emission tomography/computed tomography (PET/CT) in patients with stage I lung adenocarcinoma.We reviewed 127 consecutive patients with pathologically proven stage I lung adenocarcinoma who underwent pretreatment [18F]FDG PET/CT scans in our hospital from 2005 June to 2012 June. The maximum, mean, and peak standardized uptake value (SUVmax, SUVmean, and SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and computed tomography volume (CTV) were measured. The Kaplan–Meier and Cox proportional hazards model were used with age, gender, TNM stage, clinical stage, histological grade, nodule type, tumor size, and metabolic parameters to predict progression-free survival (PFS). The cut-off point was determined through receiver-operating characteristic curve.In univariate analysis, the histological grade, nodule type, diameter (cut-off value of 2.0 cm), CTV (6.56 cm3), SUVmax (3.25 g/mL), SUVmean (1.58 g/mL), SUVpeak (1.84 g/mL), MTV (4.80 cm3), and TLG (10.40) were significantly associated with PFS (all P value < .05). Patients with poorly differentiated adenocarcinoma, solid nodule type, large size, and high metabolic tumor burden were associated with poor prognosis. In multivariate analysis, only histological grade was independent prognostic factors for progression with a P value of .005 (RR, 0.355; 95% CI, 0.173–0.728). Among 5 PET/CT metabolic parameters, only MTV was independent prognostic factors for progression with a P value of .031 (RR, 1.118; 95% CI, 1.010–1.237).Histological grade was an independent predictor for progression in patients with stage I lung adenocarcinoma. Among 5 PET/CT metabolic parameters, only MTV was an independent predictor for progression.

O7 Brainstem evoked potentials (BEP) z score is a predictor of disability progression in patients with clinically isolated syndrome

Objectives To investigate the role of brainstem evoked potentials (BEP) z score as a predictor of disability progression in patients with clinically isolated syndrome (CIS). Methods Inthirty-two CIS patients (22 females, mean age 32.56 ± 7.68) latencies of the major components of vestibular evoked myogenic potentials (P13, N23, N10 and P13), brainstem auditory evoked potentials (III and V wave), tongue (P1) and median nerve (P14) somatosensory evoked potentials were analyzed and z score for each EP was calculated and combined into BEP z score. EDSS and brain MRI were performed. Disability progression was defined as an increase in EDSS after one-year of follow-up. The following baseline predictors were analyzed: EDSS, brainstem lesions on the brain MRI and BEP score. Results Median EDSS of the group was 1.5, and 12 (37.5%) patients had brainstem MRI lesions. Mean BEP z score was 0.0272 ± 0.4783. EDSS increase after one year was identified in 9 (28.1%) patients. Patients with the increase in EDSS had significantly higher BEP z score at baseline, p = 0.027. Results of the multivariate regression analysis revealed BEP z score corrected for EDSS at the baseline and the presence of MR brainstem lesions as a significant predictor of disability progression (OR 12.645, 95%CI 1.08–147.71, p = 0.043). Discussion The presence of MRI brainstem lesions has been identified as one of the major predictive factors for future disability. Conclusion BEP z score is associated with disability progression one year after CIS. Significance Brainstem dysfunction is an important predictor of future disability in CIS. This study was partially funded by the Installation Research project HRZZ UIP-11-2013-2622 of the Croatian Science Foundation.

Predictors of progression of atrial fibrillation in patients with congestive&#x0D; heart failure

An appreciable progress has recently been achieved in the study of the nature of atrial fibrillation (AF), from its early asymptomatic stages to irreversible arrhythmia. There are data on the risk factors of AF in the literature, but predictors of progressive arrhythmia remain to be elucidated. This study was aimed to identify predictors of AF progression in patients with congestive heart failure (CHF). Material and methods. The study involved 64 patients aged 59-82 (mean 69,4±3,9) followed up prospectively from September 2010 till June 2016 (observations of mean duration 60±3 mo included regular telephone interviews (each 3 mo) and annual general clinical examination with laboratory and instrumental studies. Continuous or persisting AF served as the criterion for progressive arrhythmia. Results. Cardiovascular complications and progressive arrhythmia were documented in 23 (36%) and 38 (59%) patients respectively during the 60±3 mo observation period. The multifactorial analysis revealed the significant influence of a decrease of left ventricular ejection function (EF) to below 40% and a rise in the plasma level of brain natriuretic peptide (Nt-proBNP) to more than 903 pg/ml on the risk of development of arrhythmia. Conclusion. Independent predictors of arrhythmia in patients with CHF and persistent AF are a decrease in left ventricular ejection function (EF) to below 40% (1,2, 95% CI 0,9-1,5) and a rise in the plasma Nt-proBNP level to more than 903 pg/ml (OR 1,3, 95% , CI+1,1-2,9). Such a rise predicts transition of arrhythmia into continuous form with sensitivity 92,1% and specificity 84,6%.

Serum levels of leptin and high molecular weight adiponectin are inversely associated with radiographic spinal progression in patients with ankylosing spondylitis: results from the ENRADAS trial

BackgroundPrevious research indicates a role of adipokines in inflammation and osteogenesis. Hence adipokines might also have a pathophysiological role in inflammation and new bone formation in patients with ankylosing spondylitis (AS). The aim of this study was to investigate the role of adipokine serum levels as predictors of radiographic spinal progression in patients with AS.MethodsA total of 120 patients with definite AS who completed a 2-year follow up in the ENRADAS trial were included in the current study. Radiographic spinal progression was defined as: (1) worsening of the modified Stoke Ankylosing Spondylitis spine (mSASSS) score by ≥2 points and/or (2) new syndesmophyte formation or progression of existing syndesmophytes after 2 years. Serum levels of adipokines (adiponectin (APN) and its high molecular weight form (HMW-APN), chemerin, leptin, lipocalin-2, omentin, resistin, visfatin) were measured using enzyme-linked immunosorbent assays.ResultsThere was a significant association between radiographic spinal progression and both leptin and HMW-APN. Baseline serum levels of both adipokines were lower in patients who showed radiographic spinal progression after 2 years. This association was especially evident in men; they had generally lower leptin and HMW-APN serum levels as compared to women. The inverse association between adipokines and radiographic spinal progression was confirmed in the logistic regression analysis: the odds ratios (OR) for the outcome “no mSASSS progression ≥2 points” were 1.16 (95% CI 1.03 to 1.29) and 1.17 (95% CI 0.99 to 1.38), for leptin and HMW-APN, respectively; for “no syndesmophyte formation/progression” the respective OR were 1.29 (95% CI 1.11 to 1.50) and 1.18 (95% CI 0.98 to 1.42), adjusted for the presence of syndesmophytes at baseline, C-reactive protein at baseline, sex, body mass index (BMI), non-steroidal anti-inflammatory drugs intake score over 2 years, and smoking status at baseline.ConclusionSerum leptin and HMW-APN predict protection from spinal radiographic progression in patients with AS. Women generally have higher leptin and HMW-APN serum levels that might explain why they have less structural damage in the spine as compared to male patients with AS.Trial registrationEudraCT: 2007-007637-39. ClinicalTrials.gov, NCT00715091. Registered on 14 July 2008.

Progressive Decline of Lung Function in Rheumatoid Arthritis-Associated Interstitial Lung Disease.

Interstitial lung disease (ILD) is associated with substantial morbidity in rheumatoid arthritis (RA), but very little is known about its long-term progression. This study was undertaken to investigate the progression of pulmonary disease using a large single-center cohort of patients with RA-associated ILD. Records of all patients with RA-associated ILD seen at Mayo Clinic between 1998 and 2014, with at least 4 weeks follow-up and at least 1 pulmonary function test, were identified and manually screened for study inclusion. Progression was defined as a diffusing capacity for carbon monoxide (DLco) <40% predicted (or patients whose illness was too advanced to undergo screening) or a forced vital capacity (FVC) <50% predicted. Time to progression was analyzed using the Kaplan-Meier method. Of the 167 patients included in the study, 81 (49%) were female, with a mean ± SD age of 67 ± 10 years at diagnosis of ILD. Median follow-up time from diagnosis of ILD was 3.3 years (range 0.01-14.8). One-third of the patients required supplemental oxygen, 40% developed DLco <40% predicted, and 22% developed FVC <50% predicted within 5 years after ILD diagnosis. Usual interstitial pneumonia (UIP) versus nonspecific interstitial pneumonia (NSIP) was a risk factor for DLco progression (hazard ratio 3.29 [95% confidence interval 1.28-8.41]). Lower DLco and FVC at baseline increased the risk for progression to DLco <40% predicted and FVC <50% predicted, and higher rates of change in the first 6 months also increased the risk of progression. Progressive loss of pulmonary function is common in RA-associated ILD and is worse in patients with UIP than in those with NSIP. Predictors of progression in patients with RA-associated ILD may aid clinicians in identifying patients at highest risk for progression of ILD.

Sa1253 Incidence Rate and Predictors of Progression in Patients' With Barrett's Esophagus: Experience From a Large Irish Tertiary Centre

Sa1253 Incidence Rate and Predictors of Progression in Patients' With Barrett's Esophagus: Experience From a Large Irish Tertiary Centre

Abstract 14870: Progression of Paroxysmal to Persistent Af in Patients Awaiting AF Ablation

Objective: Atrial fibrillation (AF) is a progressive disease for which ablation has become an important treatment option. Success rates have been shown to be significantly higher while AF has not yet progressed to persistent. In a general AF-population the HATCH-score has been proposed to predict the risk of progression to persistent AF. However, little is known about predictors of progression in patients awaiting AF ablation. Methods/Results: We performed a retrospective, single centre investigation of patients with paroxysmal AF at the time they were placed onto our AF ablation waiting list and evaluated possible risk factors for the progression of AF until the time of the actual ablation. Of 564 patients (median age 60.4 (±15.1) years, 194 (34.4%) female) 60 (11%) progressed from paroxysmal to persistent AF during a median waiting time of 291 (±244.3) days. In patients that progressed to persistent AF, ablation took significantly longer (180±99 min vs. 157±85min; p 0.009), had a tendency to require longer RF-energy delivery (68.9±40 min vs. 61.8±44 min; p 0.052) and was associated with a higher rate of recurrence (53.3% vs. 39.1%; p&lt;0.001). Patients that did progress to persistent AF had tied significantly more antiarrhythmic drugs (1 (±2) vs. 1(±1); p 0,048) and more frequently had a history of amiodaron treatment (21.7% vs. 11.9%; p 0.03). The previously proposed HATCH-score was only a poor predictor of AF progression (AUC 0.54). Furthermore, none of the individual HATCH-score parameters was a significantly predicted the progression of AF in our population. However, a left atrial (LA) diameter of more than 45mm (OR 3.46, p&lt; 0.001) and heart failure (OR 3.11, p 0.036) were strong and independent predictors of AF progression in multivariable analysis. Conclusion: Patients with an increased LA-diameter or heart failure have a significantly increased risk to progress to persistent AF. If ablation is considered in such a patient it should be conducted as soon as possible to prevent progression to persistent AF.

E48. Relationship between Clinical and Radiographic (X-Ray) Dynamics of Rheumatoid Arthritis and Predictors of X-Ray Progression in Patients with Rheumatoid Arthritis Receiving Classic Synthetic Disease-Modifying Anti-Rheumatic Drugs

E48. Relationship between Clinical and Radiographic (X-Ray) Dynamics of Rheumatoid Arthritis and Predictors of X-Ray Progression in Patients with Rheumatoid Arthritis Receiving Classic Synthetic Disease-Modifying Anti-Rheumatic Drugs

Predictors of progression in patients presenting with minor subcortical stroke.

Early neurological worsening is common in minor subcortical strokes (SS) and may lead to a poor outcome. We aimed to describe clinical and imaging features associated with progression. Consecutive patients with SS were divided into progressive and non-progressive. Progression was defined as an increase of NIHSS motor score ≥ 1 point within 72 h from onset. Vascular risk factors and imaging features (vascular territory, size and number of slices in which the lesion was visible, the presence of leukoaraiosis) were compared in the two groups. We investigated potential independent determinants of progression using stepwise logistic regression. Thirty of 94 patients (31.9%) underwent progression. The distribution of vascular risk factors did not differ significantly between the two groups. Increasing number of risk factors was associated with a higher risk of progression (OR 2.2; 95% CI 1.1-4.5). Patients who progressed were more likely to have a lesion ≥ 15 mm in diameter (P = 0.004) or a lesion visible ≥ 3 slices (P = 0.007). After logistic regression stepwise adjustment for all the considered potential determinants, diameter ≥ 15 mm and severe leukoaraiosis proved to be independently associated with neurological worsening (OR = 6.3, 95% CI 2.0-19.6 and OR = 5.9, 95% CI 1.3-25.7, respectively). In a series of consecutive SS, early neurological worsening was associated with a high vascular risk profile, a larger infarct size and the presence of severe leukoaraiosis. Based on the knowledge that extensive microvascular changes are a feature of severe leukoaraiosis, we hypothesize that stroke progression could be promoted through an impaired compensatory flow in the penumbral area.

Overexpression of ribonuclease inhibitor defines good prognosis and suppresses proliferation and metastasis in human colorectal cancer cells via PI3K/AKT pathway

We aim to evaluate the diagnostic value of ribonuclease inhibitor (RI) in colorectal cancer (CRC) and investigate the important role of RI in cell growth and metastasis of CRC. In this study, the expression of RI was evaluated in human CRC samples with different histological grade and the association between RI expression and clinicopathological parameters was investigated. Furthermore, the exogenous RI gene was introduced into human HT29 CRC cells and the effects of RI on cell proliferation and metastasis were determined in vitro. The PI3K/Akt signaling pathway and some related protein molecules were detected. RI is downregulated in CRC tissues compared to adjacent normal tissues and its expression is inversely associated with histological grade, pathological stage, and venous invasion, respectively. Multivariate analysis showed that RI expression was an independent prognostic factor for overall survival. In addition, the exogenous overexpression of RI reduced the proliferation and migration of HT29 CRC cell line in vitro by inhibiting the PI3K/Akt signaling pathway and suppressing the expression of vascular endothelial growth factor (VEGF) and upregulating phosphatase and tensin homolog (PTEN). RI represents an important predictor of progression in patients with CRC and suppresses proliferation and metastasis in CRC cells through inhibiting PI3K/AkT pathway.

SAT0332 Connective Tissue Degradation by Matrix Metalloproteinases (C1M) is Predictive of Radiographic Progression in Ankylosing Spondylitis Preferentially in Patients Who Smoke

BackgroundAnkylosing spondylitis (AS) is a chronic inflammatory, rheumatic disease predominately affecting the axial skeleton. It is a slowly progressing disease which can be described by excessive connective tissue remodelling. Early...

Predictors of progression in patients with high-grade appendiceal or colorectal adenocarcinoma after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

e14573 Background: High-grade peritoneal carcinomatosis (PC) secondary to appendiceal or colorectal cancer is marked by short progression-free survival (PFS) and overall survival. Treatment include...