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| 1 | 前庭性偏头痛:诊断标准——Barany学会及国际头痛学会共识文件显示文摘本文提供了前庭性偏头痛的诊断标准,由Barany学会前庭疾患分类委员会及国际头痛学会(IHS)偏头痛分类分委员会共同制定。分类包括前庭性偏头痛及很可能的前庭性偏头痛。与IHS的常规程序相同,前庭性偏头痛作为一种新分类,将首先出现在第3版国际头痛分类(ICHD-3)的附录中。若积累了进一步的证据,很可能的前庭性偏头痛也许会纳入更晚的ICHD版本中。前庭性偏头痛的诊断建立在反复发作的前庭症状、具有偏头痛病史、前庭症状与偏头痛症状间存在时间上的相关性,并排除其他可导致前庭症状的病因。符合前庭性偏头痛诊断的症状包括不同类型的眩晕及头部活动诱发的头晕伴恶心。症状的严重程度必须为中重度。急性发作的持续时间限于5 min^72 h的时间窗内。 | 华驾略 李焰生 Lempert T Olesen J Furman J Waterston J Seemungal B Carey J Bisdorff A Versino M Evers S Newman-Toker D | 2013 | 神经病学与神经康复学杂志2013，10，3： | 60 |
| 2 | Overexpression of ADAM9 in non-small cell lung cancer correlates with brain metastasis显示文摘The 'a disintegrin and metalloprotease' (ADAM) family contributes to regulation of the cell-cell and cell-matrix interactions that are critical determinants of malignancy. To determine the relationship between metastasis and ADAM proteins, we compared the mRNA levels of ADAM9,-10,-12,-15, and-17 in sublines of an EBC-1 lung cancer cell line that were highly metastatic to either brain or bone. ADAM9 mRNA levels were significantly higher in highly brain-metastatic sublines than in the parent or highly bonemetastalic sublines. To elucidate the role ofADAM9 in brain metastasis, we stably transfected A549 and EBC-1 cells with a fulllength ADAM9 expression vector. Compared with mock-transfectants, ADAM9 overexpression resulted in increased invasive capacity | Shintani Y Higashiyama S Ohta M Hirabayashi H Yamamoto S Yoshimasu T Matsuda H Matsuura N | 2004 | 中国神经肿瘤杂志2004，2，2： | 36 |
| 3 | AGNP精神科治疗药物监测共识指南:2011显示文摘治疗药物监测(Therapeutic drug monitoring,TDM),如通过定量测定血清或血浆药物浓度指导用药剂量优化,已经成为对患者进行精神药物治疗的很有价值的工具。在患者用药依从性难以判断、药物耐受性不佳、治疗剂量下无效以及可能存在药代动力学药物-药物相互作用等情况下,测定药物浓度是很有用的。在精神科,有可能明显获益于TDM的主要患者群体包括儿童、孕妇、老年患者、智力障碍患者、涉及司法的患者、已知或怀疑携带药代动力学相关基因变异的患者,以及合并躯体疾病影响药代动力学的患者。然而,只有将TDM充分整合到临床治疗过程中去,才能发挥其优化药物治疗的潜在优势。为了促进TDM的合理应用,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie,AGNP)的TDM专家组在2004年发表了精神药物治疗药物监测指南。之后,随着知识不断更新,又有许多可能需要进行TDM的新药上市。因此,本次更新将神经精神药物的种类扩展到了128种,并将其TDM必要性划分为从'强烈推荐'到'可能有用'的四个等级。经过大量细致且全面的文献检索与分门别类的汇总整理,将基于循证医学理念的'治疗参考浓度范围'和'剂量相关参考浓度范围'呈现给大家。本共识指南引入了'实验室警戒浓度'的新概念,即实验室需要马上告知治疗医生的药物浓度上限。本共识指南还给出了诸如药物作为细胞色素P450酶的底物和抑制剂的性质,代谢物与母药浓度比值的常见范围,以及与结果解释相关的内容,还提供了何时将TDM与遗传药理学检测相结合的建议。遵循本指南,有助于改善许多患者精神药物治疗的效果,特别是那些存在药代动力学异常的患者。TDM是一门交叉学科,有时针对看起来不一致的数据,需要多学科坦诚地讨论,只有这样,患者才能从这种合作中获益。 | Hiemke C Baumann P Bergemann N Conca A Dietmaier O Egberts K Fric M Gerlach M Greiner C Gründer G Haen E Havemann-Reinecke U Jaquenoud Sirot E Kirchherr H Laux G Lutz UC Messer T Müller MJ Pfuhlmann B Rambeck B Riederer P Schoppek B Stingl J Uhr M Ulrich S Waschgler R Zernig G 李文标(译) 果伟(译) 阮灿军(译) 贺静(译) 汤宜朗(审校) 王传跃(审校) | 2016 | 实用药物与临床2016，19，10： | 37 |
| 4 | 急性缺血性卒中的血管内治疗:神经介入外科学学会实践标准委员会的报告显示文摘目的总结采用血管内技术治疗急性缺血性卒中的有关证据并等级分类。方法对美国心脏协会(American Heart Association,AHA)以前发表的推荐意见进行审查并作为当前流程的基础。在此这基础上,进行系统的文献回顾以评估支持急性缺血性卒中血管内治疗的证据。根据AHA卒中委员会和牛津大学循证医学中心提出的循证医学证据分级指南进行评估。对操作安全性、技术效果以及对临床转归的影响进行特别审核。 | K A Blackham P M Meyers T A Abruzzo F C Alberquerque D Fiorella J Fraser D Frei C D Gandhi D V Heck J A Hirsch D P Hsu M Jayaraman S Narayanan C Prestigiacomo J L Sunshine 包元飞(译) 李永坤(译) 刘新峰(译) | 2012 | 国际脑血管病杂志2012，20，12： | 28 |
| 5 | 美国国立老化研究所与阿尔茨海默病协会诊断指南写作组:阿尔茨海默病临床前阶段的定义显示文摘阿尔茨海默病(AD)的病理生理过程在痴呆诊断的多年前就开始了。这一长期的AD“临床前”阶段是治疗干预的关键机会,但需进一步阐明AD的病理级联过程和临床症状出现之间的联系。美国国立老化研究所和AD协会召集了一个国际工作组对AD生物标志物、流行病学和神经心理学的证据进行综述并提出建议,以确定能够预测由“正常”认知到轻度认知功能障碍(MCI)及AD痴呆的最佳预测指标。根据目前已有的主要科学证据,我们提出了一个概念性的框架和用于操作的研究标准,以通过纵向临床研究来验证和改进这些模型。这些建议仅用于研究目的,目前不涉及临床应用。我们希望这些建议能提供一个共识,以推进临床前AD的研究,最终推动更早期治疗干预的进展,使得一些疾病减缓药物的疗效发挥最大。 | Sperling RA Aisen PS Beckett LA Bennett DA Craft S Fagan AM Iwatsubo T Jack CR Jr Kaye J Montine TJ Park DC Reiman EM Rowe CC Siemers E Stern Y Yaffe K Carrillo MC Thies B Morrison-Bogorad M Wagster MV Phelps CH 贾建平(译) 郭起浩(译) 黄丽(译) 陆璐(译) 张逸驰(译) 邢怡(译) | 2012 | 中华神经科杂志2012，45，5： | 22 |
| 6 | 皮质下小血管病诊断的共识声明显示文摘血管性认知损害是用于描述一组涉及大血管和小血管的散发性和遗传性异质性疾病的诊断术语。皮质下小血管病可导致腔隙性梗死和进行性白质损害。被称为宾斯旺格病(Binswanger's disease, BD)的进行性白质损害患者构成了从单纯血管性疾病到合并神经变性病变的疾病谱。BD患者是一个相对同质性的亚组,存在缺氧缺血、腔隙性梗死和炎症,它们协同作用破坏血脑屏障和髓鞘。通过临床、脑脊液、神经心理学和影像学检查获得的多模式疾病标记物能促进该亚组患者的鉴别。本共识声明确定了一系列基于基础病理学改变的潜在生物学标记物,这将有助于诊断以及将来协作性治疗试验的患者选择。 | Gary A Rosenberg Anders Wallin Joanna M Wardlaw Hugh S Markus Joan Montaner Leslie Wolfson Costantino Iadecola Berislav V Zlokovic Anne Joutel Martin Dichgans Marco Duering Reinhold Schmidt Amos D Korczyn Lea T Grinberg Helena C Chui Vladimir Hachinski 王训师 张劼 陈涵丰 俞娅美 徐子奇 罗本燕 | 2016 | 国际脑血管病杂志2016，24，6： | 18 |
| 7 | Modified boron neutron capture therapy for malignant gliomas performed using epithermal neutron and two boron compounds with different accumulation mechanisms: an efficacy study based on findings on neuroimages显示文摘 | Miyatake S Kawabata S Kafimoto Y Aoki A Yokoyama K Yamada M Kuroiwa T Tsuji M Imahori Y Kirihata M Sakurai Y Masunaga S Nagata K Maruhashi A Ono K | 2005 | 中国神经肿瘤杂志2005，3，4： | 14 |
| 8 | EFNS的神经病理性痛药物治疗指南:2010修订显示文摘背景和目的欧洲神经病学协会联盟第2届工作组的目的是对2005年以来的关于神经病理性痛的药物治疗证据进行更新。方法使用Cochrane数据库和Medline选择相关研究,并根据病因学对研究分类。所有Ⅰ类和Ⅱ类随机对照研究(RCTs)均入选,低级别研究仅在没有高级别研究的情况下入选。考虑到对门诊患者治疗的可行性,只选择单药治疗或重复给药的研究。结果多数大型RCT的研究对象是糖尿病性多发性神经病和疱疹后神经痛的患者,越来越多的小型研究则对其他病因导致的神经病理性痛的治疗进行了探索。总体而言,药物治疗在除三叉神经痛、慢性神经根病和人类免疫缺陷病毒(HIV)神经病以外的各种病因中疗效相当,A级证据支持下列药物用于治疗神经病理性痛:三环类抗抑郁剂(TCA)、普瑞巴林、加巴喷丁、曲马多和阿片类(在不同情况下)、度洛西汀、文拉法辛、局部利多卡因和辣椒素贴剂(在限定的情况下)。联合用药有效仅见于TCA与加巴喷丁、加巴喷丁与阿片类(A级证据)。结论目前仍然缺乏大型的对比研究。我们建议今后的研究使用标准化工具对共病情况、生活质量、临床症状和体征进行评估,并致力于更好地确定对特定药物治疗的反应情况。 | 李建萍 李颖 林智 李焰生 Attal N Cruccua G Barona R Haanpa M Hanssona P Jensena S Nurmikk T | 2012 | 神经病学与神经康复学杂志2012，9，1： | 14 |
| 9 | 内脏脂肪组织通过产生骨桥蛋白调控成纤维细胞衰老促进心脏衰老显示文摘老化通过增加包括骨桥蛋白(osteopontin,OPN)在内的细胞外基质(extracellular matrix,ECM)蛋白的沉积引起心脏结构和功能改变进而导致进行性间质纤维化。虽然已知OPN参与各种病理状况,但其在心肌衰老中的作用仍不清楚。 | Sawaki D Czibik G Pini M Ternacle J Suffee N Mercedes R Marcelin G Surenaud M Marcos E Gual P Clément K Hue S Adnot S Hatem SN Tsuchimochi I Yoshimitsu T Hénégar C Derumeaux G 刘青 叶鹏 | 2018 | 中华高血压杂志2018，26，3： | 14 |
| 10 | 蛋白酶激活受体2在载脂蛋白E缺陷小鼠的血管炎症和动脉粥样硬化中发挥关键作用显示文摘凝血系统与血管炎症密切相关,尽管其潜在机制仍不清楚。最近的研究结果表明,蛋白酶激活受体(protease-activated receptor,PAR)2——活化因子X(activated factor X,FXa)的主要受体之一——在血管细胞和白细胞中均有表达,这提示PAR-2可能参与炎症性疾病的发病机制。 | Hara T Phuong PT Fukuda D Yamaguchi K Murata C Nishimoto S Yagi S Kusunose K Yamada H Soeki T Wakatsuki T Imoto I Shimabukuro M Sata M 刘青 叶鹏 | 2018 | 中华高血压杂志2018，26，6： | 11 |
| 11 | 脑卒中后个体化指导的有效性和安全性显示文摘防止脑卒中后长期功能衰退的干预措施是否安全有效,目前还缺乏相关证据。该研究是一项多中心、单盲、随机对照试验,目的是评估一项个体化身体活动和锻炼指导的有效性和安全性。纳入年龄≥18岁、在社区居住的、首发或复发性脑卒中后10~16周、改良Rankin量表评分〈5分且无严重合并症的成年脑卒中患者,随机分为对照组和干预组。干预组每个月定期接受身体活动和锻炼的个体化指导,连续18个月。对照组则接受标准治疗。 | 叶超毅 叶鹏 Askim T Langhammer B Ihle-Hansen H Gunnes M Lydersen S Indredavik B | 2018 | 中华高血压杂志2018，26，1： | 10 |
| 12 | 血浆亲环蛋白A水平对冠状动脉疾病患者预后的影响显示文摘氧化应激状态下,血管平滑肌细胞、炎症细胞分泌亲环蛋白A(cyclophilin A,CyPA),并激活血小板功能。最近研究表明,血浆CyPA水平是诊断冠状动脉疾病的新型生物标志物。血浆CyPA水平对这些患者的预后是否有影响仍未阐明。方法:连续纳入接受诊断性冠状动脉造影的患者511例,测定血浆CyPA水平、高敏C反应蛋白(high-sensitivity C-reactive protein,hsCRP)和血浆脑钠尿肽水平, | Ohtsuki T Satoh K Omura J Kikuchi N Satoh T Kurosawa R Nogi M Sunamura S Yaoita N Aoki T Tatebe S Sugimura K Takahashi J Miyata S Shimokawa H 刘莉 叶鹏 | 2017 | 中华高血压杂志2017，25，2： | 9 |
| 13 | 澳大利亚临床共识指南:儿童卒中的诊断和急性期处理显示文摘卒中是导致儿童死亡的十大原因之一,幸存的致残患儿将面临几十年的残疾生活,给患儿及其家庭带来了巨大负担。由于安全性和有效性的证据有限,以及诊断的延误,目前卒中患儿无法接受再灌注治疗。儿童卒中诊断和急性期处理的澳大利亚临床共识指南,旨在最大限度地减少临床诊疗中的不确定性,并记录与成人卒中不同的危险因素、病因和假性卒中情况的最佳证据。临床问题的阐述来自于对2007年至2017年数据库的系统检索,但仅限于英语和儿科研究。该指南应用SIGN方法和国家健康与医学研究委员会系统对证据进行筛选和分类,通过推荐、评估、发展和评价系统(GRADE系统)对推荐进行强弱分级。该指南提供了60多项基于证据的推荐,以帮助参与院前和急症处理的临床医师快速识别儿童卒中,选择最合适的初步检查方案来确定诊断、明确病因,并选择最恰当的干预措施以挽救脑组织、预防复发。同时,指南也提供了颅内压和先天性心脏病管理方面的推荐。该指南的实施需要将院前和急诊系统重组,包括建立区域性卒中网络,建立儿科卒中疾病编码,快速MRI,以及对能够提供再灌注治疗的初级儿科卒中中心进行认证。该指南能够审核治疗的基准时间线,获得急性期的干预措施及预后判断。它还将促进澳大利亚儿童卒中登记的发展,并与国际登记处建立数据联系,以便准确收集卒中发病率、治疗和结果相关的数据。 | Medley TL Miteff C Andrews I Ware T Cheung M Monagle P Mandelstam S Wray A Pridmore C Troedson C Dale RC Fahey M Sinclair A Walsh P Stojanovski S Macka MT 徐佳丽(译) 吴川杰(译) 肖潇(译) 吕俊萱(译) 张博维(译) 吉训明(译) | 2019 | 中国脑血管病杂志2019，16，4： | 9 |
| 14 | 中俄联合火星电离层星-星掩星探测显示文摘中俄联合火星星-星掩星探测是人类首次在火星空间环境进行此类的联合试验。用于探测火星电离层的星-星掩星技术较以前星地间的探测技术相比,有可接收高信噪比信号,反演精度高,可探测火星上太阳天顶角大于43°,或者小于138°的区域电离层等优点。本文介绍了中俄联合火星星-星掩星探测方案、基本原理,给出了主要技术指标、地面模拟测试结果。 | 孙越强 杜起飞 朱光武 吴季 陶鹏 白伟华 赵华 胡雄 吴小成 郑建华 A S Kosov T K Breus V M Gotlib A M Krymskii A V Zakharov | 2009 | 空间科学学报2009，29，5： | 9 |
| 15 | Alcohol dehydrogenase: A potential new marker for diagnosis of intestinal ischemia using rat as a model显示文摘AIM: Intestinal ischemia (Ii) is an abdominal emergency due to blockade of the superior mesenteric artery resulting in 60-100% mortality if diagnosed late. Changes in several biochemical parameters such as D (-)-lactate, Creatinine kinase isoenzymes and lactate dehydrogenase suggested for early diagnosis, lack specificity and sensitivity. Therefore a biochemical parameter with greater sensitivity needs to be identified.METHODS: Wistar male rats were randomly assigned into two groups; control sham operated (n = 24) and ischemic test (n = 24) group. Superior mesenteric arterial occlusion was performed in the ischemic test group for 1 h. Alcohol dehydrogenase (ADH) was estimated in blood from portal vein, right ventricle of heart, dorsal aorta (DA) and inferior vena cava (IVC). The Serum glutamic acid pyruvate transaminase (SGPT) was also estimated in blood from portal vein and right ventricle of heart.RESULTS: A significant increase (P<0.001) in the levels of ADH in both portal blood as well as heart blood of the test group (232.72±99.45 EU and 250.85±95.14 EU, respectively)as compared to the control group (46.39±21.69 EU and 65.38±30.55 EU, respectively) were observed. Similarly,increased levels of ADH were observed in blood samples withdrawn from DA and IVC in test animals (319.52±80.14EU and 363.90±120.68 EU, respectively) as compared to the control group (67.68±63.22 EU and 72.50±58.45 EU,respectively). However, in test animals there was significant increase in SGPT in portal blood (P = 0.054) without much increase in heart blood.CONCLUSION: Significant increase in the levels of ADH in portal and heart blood within 1 h of SMA occlusion without increase in SGPT in heart blood, suggests that the origin of ADH is from ischemic intestine and not from liver. Similarly, raised ADH levels were found in DA and IVC as well. IVC blood does represent peripheral blood sample. A raised level of ADH in test animals confirms it to be a potential marker in the early diagnosis of Ii. | Upendra R Gumaste Mukund M Joshi Devendra T Mourya Pradip V Barde Ghanshyam K Shrivastav Vikram S Ghole | 2005 | World Journal of Gastroenterology2005，11，6： | 9 |
| 16 | 根据血压等级确定脑卒中和冠状动脉粥样硬化性心脏病死亡的终生风险:日本EPOCH(观察队列的心血管预防证据)研究显示文摘在亚洲人群中.很少研究关注根据血压分类确定脑卒中和冠状动脉粥样硬化性心脏病(coronary heartdisease,CHD)的终生风险。该研究旨在用一个包含个体参与者数据的荟萃分析大数据库来评估它。该荟萃分析纳入来源于13个队列的107 737名日本人(男性占42.4%,平均年龄55.1岁)。在平均(15.2±5.3)年(1 559 136人年)的随访期.1922人死于脑卒中,913人死于CHDO研究者在调整其他死亡危险因素后估计风险。 | 陈嘉睿(译) 练桂丽(审校) Satoh M Ohkubo T Asayama K Murakami Y Sugiyama D Yamada M Saitoh S Sakata K Irie F Sairenchi T Ishikawa S Kiyama M Ohnishi H Miura K Imai Y Ueshima H Okamura T EPOCH-JAPAN research group | 2019 | 中华高血压杂志2019，27，4： | 9 |
| 17 | 未固结流砂地层采油过程中出砂情况模拟实验显示文摘为了研究未固结流砂储集层在采油过程中的出砂情况和影响出砂的主要因素,进行了不同条件下的出砂过程模拟实验。使用水洗白砂、黏土(高岭土)和蒸馏水制成未固结流砂地层模型,利用新开发的出砂模拟装置进行了模拟实验,并分析了作用于地层的拖曳力和地层胶结特征对出砂的影响。研究表明,随着拖曳力的增加,出砂速度和产油速度都加快;随着胶结物含量的增加,出砂量和产油量明显降低,甚至在胶结物含量较高的情况下出砂量几乎为零。地层压力大的油藏在开采期间由于产生了较大的拖曳力更可能出砂,而拖曳力和有效地层应力共同影响油藏的总体产油量。可以根据地层黏土含量估计出砂情况,从而通过采取适当的防砂措施尽可能减少出砂量。某些情况下油藏比气藏更容易出砂。 | PERERA M S A RANJITH P G RATHNAWEERA T D DE SILVA G P D LIU T | 2017 | 石油勘探与开发2017，44，5： | 8 |
| 18 | Development of an Arabic version of the National Eye Institute Visual Function Questionnaire as a tool to study eye diseases patients in Egypt显示文摘AIM:To develop and test an Arabic version of the National Eye Institute Visual Function Questionnaire-25(NEI-VFQ-25).METHODS:NEI-VFQ-25 was translated into Arabic according to WHO translation guidelines. We enrolled adult consenting patients with bilateral chronic eye diseases who presented to 14 hospitals across Egypt from October to December 2012, and documented their clinical findings. Psychometric properties were then tested using STATA.RESULTS:We recruited 379 patients, whose mean age was(54.5±15)y. Of 46.2% were males, 227 had cataract,31 had glaucoma, 23 had retinal detachment, 37 had diabetic retinopathy, and 61 had miscellaneous visual defects. Non-response rate and the floor and ceiling numbers of the Arabic version(ARB-VFQ-25) were calculated. Internal consistency was high in all subscales(except general health), with Cronbach-α ranging from0.702-0.911. Test-retest reliability was high(intraclass correlation coefficient 0.79).CONCLUSION:RB-VFQ-25 isareliableandvalidtool for assessing visual functions of Arabic speaking patients. However, some questions had high non-response rates and should be substituted by available alternatives. Our results support the importance of including self-reported visual functions as part of routine ophthalmologic examination. | Nizar Saleh Abdelfattah Mohamed Amgad Ahmed A Salama Marina E Israel Ghada A Elhawary Ahmed E Radwan Mohamed M Elgayar Tamer M EL Nakhal Islam T Elkhateb Heba A Hashem Doha K Embaby Amira A Elabd Reem K Elwy Magdi S Yacoub Hamdy Salem Mohamed Abdel-Baqy Ahmad Kassem | 2014 | International Journal of Ophthalmology(English edition)2014，7，5： | 8 |
| 19 | 急性脊髓损伤患者治疗的临床操作指南:关于MRI基线在临床治疗决策与结果预测中作用的几点建议(英文)显示文摘The objective of this guideline is to outline the role of magnetic resonance imaging(MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury(SCI).Methods A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI.This review focused on longitudinal studies that controlled for baseline neurologic status.A multidisciplinary Guideline Development Group(GDG) used this information,their clinical expertise,and patient input to develop recommendations on the use of MRI for SCI patients.Based on GRADE(Grading of Recommendation,Assessment,Development and Evaluation),a strong recommendation is worded as ' we recommend,' whereas a weaker recommendation is indicated by 'we suggest.' Results Based on the limited available evidence and the clinical expertise of the GDG,our recommendations were:(1) 'We suggest that MRI be performed in adult patients with acute SCI prior to surgical intervention,when feasible,to facilitate improved clinical decision-making'(quality of evidence,very low) and(2) 'We suggest that MRI should be performed in adult patients in the acute period following SCI,before or after surgical intervention,to improve prediction of neurologic outcome '(quality of evidence,low).Conclusions These guidelines should be implemented into clinical practice to improve outcomes and prognostication for patients with SCI. | Fehlings MG Martin AR Tetreault LA Aarabi B Anderson P Arnold PM Brodke D Burns AS Chiba K Dettori JR Furlan JC Hawryluk G Holly LT Howley S Jeji T Kalsi-Ryan S Kotter M Kurpad S Kwon BK Marino RJ Massicotte E Merli G Middleton JW Nakashima H Nagoshi N Palmieri K Singh A Skelly AC Tsai EC Vaccaro A Wilson JR Yee A Harrop JS | 2017 | 中华神经外科疾病研究杂志2017，16，6： | 8 |
| 20 | Overexpression of HSP27 and HSP70 is associated with decreased survival among patients with esophageal adenocarcinoma显示文摘BACKGROUND Overexpression of heat shock proteins(HSPs) is associated with several malignancies and contributes to the development, progression, and metastasis of cancer, in addition to the inhibition of cellular death. In recent years, there has been active research into using HSP inhibitors in several malignancies. Due to the poor prognosis of esophageal adenocarcinoma(EAC), it would be valuable to find new biomarkers for the development of cancer treatments.AIM To evaluate the expressions of HSP27 and HSP70 and their effect on survival in EAC.METHODS Immunohistochemical analyses and evaluations of HSP27 and HSP70 expression were performed on all available samples from 93 patients diagnosed with EACbetween 1990 and 2007 at two university hospitals. Fifteen cases with Barrett's metaplasia and 5 control cases from the same patient population were included in the analysis. HSP expression was quantitatively assessed and classified as high or low. Kaplan-Meier analyses and Cox regression models adjusting for age and sex as well as tumor site, stage, and grade were used to evaluate the effect on survival.RESULTS Tumor stage and surgical treatment were the main prognostic factors. High HSP27 expression in cancer cases was a strong negative predictive factor, with a mean survival of 23 mo compared to the 49 mo in cases with a low expression(P= 0.018). The results were similar for HSP70, with a poorer survival of 17 mo in cases with high HSP70 expression, in contrast to 40 mo(P = 0.006) in cases with a low expression. A Cox regression survival analysis was performed, adjusting for possible confounding factors, and higher HSP27 and HSP70 expressions remained an independent negative prognostic factor. The HSPs' correlation with survival was not affected by cancer treatments. When the analysis was adjusted for all factors, the odds ratios for HSP27 and HSP70 were 3.3(CI: 1.6–6.6, P =0.001) and 2.2(CI: 1.2–3.9, P = 0.02), respectively.CONCLUSION HSP27 and HSP70 overexpression is associated with poor survival in EAC, which is, to the best of our knowledge, reported for the first time. | Henna K S?derstr?m Juha T Kauppi Niku Oksala Timo Paavonen Leena Krogerus Jari R?s?nen Tuomo Rantanen | 2019 | World Journal of Clinical Cases2019，7，3： | 7 |
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