RESUMO
PURPOSE: This study aimed to determine the outcomes and prognostic factors associated with octogenarians who underwent pulmonary resection for lung cancer. METHODS/PATIENTS: From 2009 to 2018, 76 octogenarians underwent pulmonary surgery for lung cancer at the Kanazawa Medical University, Japan. They were divided into two groups (early and late octogenarians), and their clinicopathological characteristics and outcomes were investigated. Overall survival rates and recurrence-free survival rates were determined using Kaplan-Meier curves. Univariate and multivariate analyses were performed to identify prognostic factors. RESULTS: Limited surgery was performed more often in the late octogenarian group; however, most perioperative factors were not significantly different between the two groups. The 3-year overall survival and recurrence-free survival rates were 61.2% and 52.8%, respectively. The median observation period was 37.5 (8.9-112.3) months postoperatively. Kaplan-Meier curves showed that age ≥ 85 years (late octogenarian), smoking history, and squamous cell carcinoma on histology were associated with worse survival rates. Multivariate analysis identified age ≥ 85 years (late octogenarian) (p = 0.011) and cigarette smoking (p = 0.025) as unfavorable prognostic factors for overall survival and recurrence-free survival, respectively. CONCLUSIONS: Most octogenarians with an indication for surgery can tolerate pulmonary surgery. However, owing to the limitations of this retrospective, single-center study, future studies involving multiple-institutions are required to confirm our findings.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Pulmonares/cirurgia , Pulmão/cirurgia , Fatores Etários , Idoso de 80 Anos ou mais , Análise de Variância , Carcinoma de Células Escamosas/mortalidade , Feminino , Humanos , Japão , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/mortalidade , Masculino , Prognóstico , Intervalo Livre de Progressão , Estudos Retrospectivos , Fumar/efeitos adversos , Taxa de Sobrevida , Cirurgia Torácica Vídeoassistida , Resultado do TratamentoRESUMO
Biliary tract cancer or extrahepatic cholangiocarcinoma (ECCA) represents the sixth commonest cause of cancer in the gastrointestinal tract in western countries. We aimed to characterize the microbiota and its predicted associated functions in the biliary tract of ECCA and benign biliary pathology (BBP). Samples were taken from 100 patients with ECCA and 100 patients with BBP by endoscopic cholangio-pancreatography for DNA extraction. Ten patients with ECCA and ten with BBP were selected for microbiota studies using the V4-16S rRNA gene and sequenced in Illumina platform. Microbiota analyses included sample-to-sample distance metrics, ordination/clustering and prediction of functions. Presence of Nesterenkonia sp. and Helicobacter pylori cagA and vacA genes were tested in the 100 ECCA and 100 BBP samples. Phylum Proteobacteria dominated all samples (60.4% average). Ordination multicomponent analyses showed significant microbiota separation between ECCA and BBP (p 0.010). Analyses of 4002 operational taxonomic units with presence variation in at least one category probed a separation of ECCA from BBP. Among these, Nesterenkonia decreased, whereas Methylophilaceae, Fusobacterium, Prevotella, Actinomyces, Novosphingobium and H. pylori increased in ECCA. Predicted associated functions showed increased abundance of H. pylori virulence genes in ECCA. cagA and vacA genes were confirmed by PCR in ECCA and BBP samples. This is the first microbiota report in ECCA and BBP to show significant changes in microbial composition. Bacterial species unusual for human flora were found: Methylophilaceae and Nesterenkonia are reported in hypersaline soils, and Mesorhizobium is a nitrogen-fixing bacterium. Enrichment of virulence genes confirms previous studies suggesting that H. pylori might be associated with ECCA.
Assuntos
Ductos Biliares/microbiologia , Colangiocarcinoma/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Microbiota , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Helicobacter pylori/genética , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Proteobactérias/classificação , Proteobactérias/genética , RNA Bacteriano/genética , RNA Ribossômico 16S/genética , Adulto JovemRESUMO
We have developed a real-time, Bonner Ball-type (neutron energy range is from thermal to 15 MeV) neutron spectral measurement system (Bonner Ball Neutron Detector (BBND)) for use on board the International Space Station (ISS). From measurements taken inside STS-89 (S/MM-8), we successfully distinguished neutrons from protons and other particles in a mixed radiation field; a task hitherto considered difficult. Although the experimental period was short, only 3.5 days (January 24-27, 1998), we were able to obtain energy spectral data and the Earth's neutron dose-equivalent map for the ISS orbital conditions (altitude 400 km, orbit inclination angle 51.6 degrees). A method for calculating the neutron energy spectrum and compensating for the particle interaction with the sensors is also described in detail.