Synucleinopathies are neurodegenerative diseases char-acterized by accumulation of misfoldedα-synuclein(α-syn)inclusions in neuronal and/or glial cells.Despite differences in the underlying pathophysiology,synucle-i...Synucleinopathies are neurodegenerative diseases char-acterized by accumulation of misfoldedα-synuclein(α-syn)inclusions in neuronal and/or glial cells.Despite differences in the underlying pathophysiology,synucle-inopathies often are misdiagnosed,especially in early stages,due to the overlapping clinical symptoms[1].展开更多
Aim:Nonalcoholic fatty liver disease(NAFLD)-associated hepatocellular carcinoma(HCC)is projected to become the leading indication for liver transplantation.Previous studies indicate that tumor growth rates(TGR)may pre...Aim:Nonalcoholic fatty liver disease(NAFLD)-associated hepatocellular carcinoma(HCC)is projected to become the leading indication for liver transplantation.Previous studies indicate that tumor growth rates(TGR)may predict survival and were helpful in determining HCC surveillance intervals.Therefore,we aimed to determine its usefulness in predicting clinical outcomes and treatments.Methods:We conducted a retrospective study of hepatitis B,C and NAFLD-HCC cases.TGR was measured using 2-consecutive pre-treatment contrast-enhanced imaging studies≥25 days apart.A multivariate regression model was used to determine predictors of TGR.In addition,the Cox regression model was used to evaluate the relationship between TGR and overall survival.Results:From 2000-2019,the study cohort comprised 38,60,and 47 HBV,HCV,and NAFLD patients,respectively,with TGRs.NAFLD-HCC tumor size was inversely correlated to the extent of liver disease as measured by Child-Pugh score(7.2 cm in non-cirrhosis;3.7 cm,2.6 cm,and 2.1 cm in Child A,B,and C,respectively;P<0.001).After adjusting for baseline characteristics,the TGR per month was fastest in HBV(9.4%,95%CI:6.3%-12.5%)compared to HCV(4.9%,95%CI:2.8%-7%)and NAFLD patients(3.6%,95%CI:1.6%-6.7%).Predictors of TGR included elevated AFP,low albumin,and smaller tumor size.Fast TGR in viral etiologies had higher mortality[adj.hazard ratio(HR)=2.6,95%CI:1.2-5.7,P=0.02]than slow TGRs,independent of treatments.Fast TGR in NAFLD had a trend towards higher mortality(HR=3.6,95%CI:0.95-13.3,P=0.059).Conclusion:NAFLD-HCC patients have more indolent growths than viral-related HCC TGRs.The addition of TGR as a biomarker may assist in stratifying treatment options.展开更多
基金supported by grants from the MSA Coalition 2017-10-007(GB)California Department of Public Health 18-10926(GB)+5 种基金The Alzheimer’s Association,The Michael J.Fox Foundation,Weston Brain Institute,and Alzheimer’s Research UK Biomarkers Across Neurodegenerative Diseases(BAND 3)17990(GB)CurePSP 665-2019-07(GB)The Michael J.Fox Foundation 18303(GB)The National Ataxia Foundation 20201551(GB and BLF),Cure Sanfilippo Foundation 20215318(GB)NIH/NIEHS ES10544(BR)generous gifts from the Karen Toffler Charitable Trust and the Binder Foundation。
文摘Synucleinopathies are neurodegenerative diseases char-acterized by accumulation of misfoldedα-synuclein(α-syn)inclusions in neuronal and/or glial cells.Despite differences in the underlying pathophysiology,synucle-inopathies often are misdiagnosed,especially in early stages,due to the overlapping clinical symptoms[1].
文摘Aim:Nonalcoholic fatty liver disease(NAFLD)-associated hepatocellular carcinoma(HCC)is projected to become the leading indication for liver transplantation.Previous studies indicate that tumor growth rates(TGR)may predict survival and were helpful in determining HCC surveillance intervals.Therefore,we aimed to determine its usefulness in predicting clinical outcomes and treatments.Methods:We conducted a retrospective study of hepatitis B,C and NAFLD-HCC cases.TGR was measured using 2-consecutive pre-treatment contrast-enhanced imaging studies≥25 days apart.A multivariate regression model was used to determine predictors of TGR.In addition,the Cox regression model was used to evaluate the relationship between TGR and overall survival.Results:From 2000-2019,the study cohort comprised 38,60,and 47 HBV,HCV,and NAFLD patients,respectively,with TGRs.NAFLD-HCC tumor size was inversely correlated to the extent of liver disease as measured by Child-Pugh score(7.2 cm in non-cirrhosis;3.7 cm,2.6 cm,and 2.1 cm in Child A,B,and C,respectively;P<0.001).After adjusting for baseline characteristics,the TGR per month was fastest in HBV(9.4%,95%CI:6.3%-12.5%)compared to HCV(4.9%,95%CI:2.8%-7%)and NAFLD patients(3.6%,95%CI:1.6%-6.7%).Predictors of TGR included elevated AFP,low albumin,and smaller tumor size.Fast TGR in viral etiologies had higher mortality[adj.hazard ratio(HR)=2.6,95%CI:1.2-5.7,P=0.02]than slow TGRs,independent of treatments.Fast TGR in NAFLD had a trend towards higher mortality(HR=3.6,95%CI:0.95-13.3,P=0.059).Conclusion:NAFLD-HCC patients have more indolent growths than viral-related HCC TGRs.The addition of TGR as a biomarker may assist in stratifying treatment options.
