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Prognostic Value of SPARC Expression in Unresectable NSCLC Treated with Concurrent Chemoradiotherapy
Kurtul, Neslihan,Eroglu, Celalettin,Unal, Dilek,Tasdemir, Erdem Arzu,Orhan, Okan,Zararsiz, Gokmen,Baran, Munevver,Kaplan, Bunyamin,Kontas, Olgun Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.20
Background: The aim of the present study was to determine the predictive/prognostic value of the secreted protein, acidic and rich in cysteine (SPARC) in cases of unresectable, locally advanced, non-small cell lung cancer. Materials and Methods: The study included 84 patients with Stage IIIA-B non-small cell lung cancer, undergoing simultaneous chemoradiotherapy including radiotherapy at a dose of 66 Gy and weekly docataxel ($20mg/m^2$) and cisplatin ($20mg/m^2$). SPARC expression was studied in biopsy material by immunohistochemical methods and correlations with treatment responses or survival were evaluated. Results: Median overall survival was $16{\pm}2.73$ (11.55-20.46) months for low expression vs $7{\pm}1.79$ months (7.92-16.08) months for high expression (p=0.039), while median local control was $13{\pm}2.31$ (8.48-17.5) months for low expression vs $6{\pm}0.85$ (4.34-7.66) months for high expression (p=0.045) and median progression-free survival was $10{\pm}2.31$ (5.48-14.5) months for low expression vs $6{\pm}1.10$ (3.85-8.15) months for high expression (p=0.022). In both univariate and multivariate analyses, high SPARC expression was associated with significantly shorter overall survival (p=0.003, p=0.007, respectively), local control (p=0.008, p=0.036) and progression-free survival (p=0.004, p=0.029) when compared to low SPARC expression. No significant difference was detected between high and low SPARC expression groups regarding age, sex, T stage, N stage, histopathology and stage-related patient characteristics. Conclusions: High SPARC expression was identified as a poor prognostic factor in cases with locally advanced NSCLC treated with concurrent chemoradiotherapy.
Axon Count and Sympathetic Skin Responses in Lumbosacral Radiculopathy
Hacer Erdem Tilki,Melek Coşkun,Neslihan Ünal Akdemir,Lütfi İncesu 대한신경과학회 2014 Journal of Clinical Neurology Vol.10 No.1
Background and Purpose Electrodiagnostic studies can be used to confirm the diagnosis oflumbosacral radiculopathies, but more sensitive diagnostic methods are often needed to measure the ensuing motor neuronal loss and sympathetic failure. Methods Twenty-six patients with lumbar radiculopathy and 30 controls were investigatedusing nerve conduction studies, motor unit number estimation (MUNE), testing of the sympathetic skin response (SSR), quantitative electromyography (QEMG), and magnetic resonancemyelography (MRM). Results Using QEMG as the gold standard, the sensitivity and specificity of MUNE for the abductor hallucis longus muscle were 71.4% and 70%, respectively. While they were 75% and 68.8%, respectively, when used MRM as gold standard. The sensitivity and specificity ofMUNE for the extensor digitorum brevis muscle were 100% and 84.1%, respectively, when theperoneal motor amplitude as the gold standard. The SSR latency was slightly longer in the patients than in the controls. Conclusions MUNE is a simple and sensitive test for evaluating autonomic function and for diagnosing lumbosacral radiculopathy in patients. MUNE could be used routinely as a guide for the rehabilitation of patients with radiculopathies. SSR measurements may reveal subtle sympathetic abnormalities in patients with lumbosacral radiculopathy.