BackgroundSmall intestine cancer (SIC) is difficult to diagnose early and presents a poor prognosis due to distant metastasis. This study aimed to develop nomograms for diagnosing and assessing the prognosis of SIC with distant metastasis.MethodsPatients diagnosed with SIC between 2010 and 2015 were included from the Surveillance, Epidemiology and End Results database. Univariate and multifactor analysis determined independent risk factors for distant metastasis and prognostic factors for overall and cancer‐specific survival. We then constructed the corresponding three nomograms and assessed the diagnostic accuracy of the nomograms by net reclassification improvement, receiver operating characteristic curves and calibration curves, assessed the clinical utility by decision curve analysis.RESULTSThe cohort consisted of 6697 patients, of whom 1299 had distant metastasis at diagnosis. Tstage, Nstage, age, tumor size, grade, and histological type were independent risk factors for distant metastasis. Age, histological type, T stage, N stage, grade, tumor size, whether receiving surgery, number of lymph nodes removed, and the presence of bone or lung metastases were predictors of both overall survival and cancer‐specific survival. The nomograms showed excellent accuracy in predicting distant metastasis and prognosis.ConclusionNomograms were developed and validated for SIC patients with distant metastasis, aiding physicians in making rational and personalized clinical decisions.
Objective: To explore the association between serum Wnt5a level and ISR, and to assess the possibility of Wnt5a to be a predictor of ISR.Methods: 184 bare metal stent (BMS) implanted patients were enrolled in this case-control study. According to coronary angiography results, all patients were divided into 2 groups: in-stent restenosis (ISR) group and non-ISR group. Serum Wnt5a levels were determined using enzyme-linked immune sorbent assay (ELISA).Results: Serum Wnt5a levels were higher in ISR group than those in non-ISR group, and were associated with the Gensini score. ISR rate was the highest in the upper tertile of Wnt5a. Multivariate logistic regression indicated that Wnt5a was an independent risk factor of ISR. For diagnosing ISR, the area under ROC curve was 0.817. The cutoff value of Wnt5a diagnosing ISR was 25.83ng/L, with the specificity of 60.68% and sensitivity of 89.55%.
Conclusion:Serum Wnt5a levels is associated with ISR in PCI patients with BMS implantation. Wnt5a is an independent risk factor of ISR, and may act as a biomarker for diagnosing ISR in BMS implanted patients.
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