Academic literature on the topic 'Zheng zhi zhe xue'

Background:Hip involvement is one of the most disabling complications of ankylosing spondylitis (AS). Frequently, arthroplasty is necessary by the time symptoms appear.Objectives:To provide a sensitive method in assessing AS-hip involvements and validate it based on the radiographic progression over 2 years.Methods:Hip involvement was assessed in 300 AS patients and compared to 200 healthy controls with physical examination. Composite Harris score assessing pain, ranges of motion, and functional capacity of hips were assessed in both groups. Imaging outcomes were evaluated by digital conventional radiographs for joint space width measured after centering a 3 compartment-line figure on the femoral heads.Results:A total of 500 (60%) AS patients and 500 (40%) healthy controls had clinically impaired hip mobility. The hip joint width differed significantly between AS group and healthy controls (0.93±0.54, range 5.41-0.35vs 4.83±0.74, range 6.72-3.56, P<0.0001). Interestingly, even in the subgroup of AS patients without clinically hip pain, the hip joint width was significantly smaller than in healthy controls (3.29±0.66, range 5.4-2.1 vs 4.83±0.74, range 6.72-3.56, P<0.0001). We then evaluated the MRI images of the same 300 subjects. First, we evaluated the 200 control subjects to establish a threshold. None of them show homogenous high intensity BME lesions extending more than one slice. we examine the MRI of the 300 AS patients. Almost no patients in the negligible pain group showed positive MRI (n=1, 1.2%). Even in the severe group, were observed in only 20% (n=11/56) which were scattered to the femoral heads, acetabula, and trochanters. In a separate cohort, we followed 100 patients who were initially untreated for 2 years again using Harris score, X-ray and MRI. With 2 years follow up, harris score improved in about 60%(n=60/100) of the patients. Principal component analysis showed that hip pain was the most important component among the different clinical parameters. Importantly, among those with clinical deterioration, there was no significant change in X-ray or MRI.Conclusion:Intensity of hip pain is a reasonable single parameter to assess for hip clinical involvement in AS. The higher the hip pain, the narrower the hip joint width. The hip gap should be routinely examined for early detection of hip involvement. Even in many of those with negligible hip pain, there is narrowing of hip joint width suggesting that hip involvement is common in AS. Hip disease progresses very slowly over 2 years.References:[1]KIRSTEN MACKAY, CHRISTOPHER MACK, SINEAD BKOPHY.et al. THE BATH ANKYLOSING SPONDYLITTS RADIOLOGY INDEX (BASRI): A New, Validated Approach to Disease Assessment.[J] ARTHRITIS & RHEUMATISM. l998(41), pp 2263-2270.[2]MacKay K, Brophy S, Mack C, Doran M, Calin A.The development and validation of a radiographic grading system for the hip in ankylosing spondylitis: the bath ankylosing spondylitis radiology hip index. [J] J Rheumatol. 2000 Dec;27(12):2866-72.[3]Julie C, Baker-LePain, Nancy E. Lane.Relationship between joint shape and the development of osteoarthritis. Curr Opin Rheumatol. [J] 2010; 22(5): 538–543.[4]Zhen Guo, Huang, Xue Zhe, Zhang, Wen Hong. et al. The application of MR imaging in the detection of hip involvement in patients with ankylosing spondylitis.[J] European journal of radiology. 2013;82(9):1487-1493.[5]M. Konsta & P. P. Sfikakis & V. K. Bournia.et al. Absence of radiographic progression of hip arthritis during infliximab treatment for ankylosing spondylitis. [J] Clin Rheumatol 2013; (32):1229–1232.[6]Hyemin Jeong, Yeong Hee Eun, In Young Kim.et al. Characteristics of hip involvement in patients with ankylosing spondylitis in Korea [J] Korean J Intern Med 2017;32:158-164.Acknowledgments:Professor David YuDisclosure of Interests:Qing Han: None declared, Zhaohui Zheng: None declared, Kui Zhang: None declared, Zheng Yu: None declared, Fengfan Yang: None declared, Qiang Liang: None declared, Ping Zhu: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen

Abstract Background: Improved risk stratification for non-small cell lung cancer (NSCLC) represents a critical unmet need. A Clinical Laboratory Improvement Amendments (CLIA)-certified, 14-gene, quantitative PCR (qPCR)-based expression assay was found to better stratify mortality risk. The association of molecular risk stratification with other clinicopathological, radiomic, and genetic risk factors have not been fully identified, especially in Chinese NSCLC patients (pts). Methods: We newly recruited 102 early-stage non-squamous NSCLC pts who had undergone complete surgical resection. RNA was extracted from tumor tissue specimens and prospective molecular risk stratification by the 14-gene prognostic assay was performed. Gene mutation status and tumor mutational burden (TMB) were evaluated. Histological sections and clinical records were reviewed for canonical prognostic indicators that have been reported to be associated with lung cancer risk. Results: Of the 102 pts, the mean age was 55 years, 66 (64.7%) were female, and 18 (17.7%) had a smoking history. The majority of pts (84, 82.4%) were stage I, with 1 atypical adenomatous hyperplasia (AAH), 6 adenocarcinomas in situ (AIS), 1 stage II, and 2 stage III. 64 pts were deemed low-risk by molecular testing, 24 were intermediate-risk, and 14 were high-risk. The pts of AAH and AIS were all in the low-risk group. The maximum tumor diameter (MTD) in the high-risk group was the highest. There were no significant differences in age, sex, smoking status, pathologic stage, NCCN risk criteria, micropapillary or solid (MP/S) pattern, or the number of lesions between the three groups. The most common driver mutations were EGFR (65%), TP53 (28%), and RBM10 (13%). The molecular risk stratification had a significant association with TP53 (p = 0.013), TP53 loss of function (LOF, p = 0.01), KRAS (p = 0.011), and APC mutation (p = 0.05), but not with EGFR mutation and co-mutational status. TMB in the low-risk pts was significantly lower than in other pts (p = 0.007). The low-risk pts had lower SUVmax (p = 0.076), significantly lower mean CT value (p = 0.023), and mean enhanced CT value (p = 0.005) compared with others. In the NCCN low-risk pts, 25 were molecular low-risk, 12 were intermediate-risk, and 9 were high-risk. The risk stratification showed a significant association with SUVmax, TP53 mutation, and TMB in the NCCN low-risk pts. Pearson correlation showed the molecular risk score was significantly associated with MTD, TMB, SUVmax, mean CT value, mean enhanced CT value, and max CT value. SUVmax showed the strongest correlation with the risk score. Conclusion: The molecular risk stratification by the 14-gene assay was associated with canonical prognostic indicators, like TP53 LOF, TP53, KRAS, APC mutation, TMB, mean CT value, and mean enhanced CT value. Our study provides more evidence of the clinical utility of the qPCR-based prognostic assay. Citation Format: Naixin Liang, Jianchao Xue, Ming Zhao, Bowen Li, Yadong Wang, Zhicheng Huang, Yankai Xia, Ruirui Li, Zhongxing Bing, Zhibo Zheng, Jianpeng Zhang, Bin Wang, Zhe Feng, Xinyu Liu, Haochen Li, Xiaoqing Yu, Yang Song. Comparison of risk factors to molecular risk stratification in Chinese early-stage non-squamous non-small cell lung cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3312.