Among the remaining 625 patients, we compared the homogeneous moderately differentiated group (HG2, n = 241), mixed histologic Inhibitor Library grades with the worst component as poorly differentiated group
(M2, n = 142), and homogeneous poorly differentiated group (HG3, n = 156). The clinicopathologic features, disease-free survival (DFS) and overall survival (OS) in each group were analyzed. The DFS and OS were significantly lower in M2 than in HG2 (P = 0.004 and 0.025, respectively) whereas those of M2 were not significantly different from HG3. There were no significant differences in the clinicopathologic features of each group except that microvascular invasion was more frequently observed in M2 than in HG2. On multivariate analysis, being in the worst histologic group (M2 and HG3) was an independent poor prognostic factor for DFS and OS (P = 0.028 and < 0.001, respectively). In patients with advanced histologic grade, the worst histologic grade may determine the prognosis after curative resection of HCC. "
“Shivkumar S, Peeling R, Jafari Y, Joseph L, Pant Pai N. Accuracy of rapid and point-of-care screening tests for hepatitis C, a systematic review and meta-analysis. Ann Intern Med 2012;157:558–566. (Reprinted with permission.) Background: 170 million persons worldwide are infected with hepatitis C, many of whom are undiagnosed. Although rapid diagnostic tests (RDTs) and point-of-care tests
(POCTs) provide a time- and cost-saving alternative to conventional laboratory tests, their BVD-523 in vitro global uptake partly depends on their performance. Purpose: To meta-analyze the diagnostic accuracy of POCTs and RDTs to screen for hepatitis C. Data Sources MEDLINE, EMBASE, BIOSIS, and Web of Science (1992 to 2012) and bibliographies of included articles. Study Selection: All studies evaluating the diagnostic accuracy of POCTs and RDTs for hepatitis C in adults (aged 18 years). Data Extraction: Two independent 上海皓元 reviewers extracted data and critiqued study quality. Data Synthesis: Of 19 studies reviewed,
18 were meta-analyzed and stratified by specimen type (whole blood, serum, plasma, or oral fluid) or test type (POCT or RDT). Sensitivity was similarly high in POCTs of whole blood (98.9% [95% CI, 94.5% to 99.8%]) and serum or plasma (98.9% [CI, 96.8% to 99.6%]), followed by RDTs of serum or plasma (98.4% [CI, 88.9% to 99.8%]) and POCTs of oral fluid (97.1% [CI, 94.7% to 98.4%]). Specificity was also high in POCTs of whole blood (99.5% [CI, 97.5% to 99.9%]) and serum or plasma (99.7% [CI, 99.3% to 99.9%]), followed by RDTs of serum or plasma (98.6% [CI, 94.9% to 99.6%]) and POCTs of oral fluid (98.2% [CI, 92.2% to 99.6%]). Limitation:Lack of data prevented sensitivity analyses of specific tests. Conclusion: Data suggest that POCTs of blood (serum, plasma, or whole blood) have the highest accuracy, followed by RDTs of serum or plasma and POCTs of oral fluids.