Prognostic Effect of Albumin-to-Globulin Ratio in Patients with solid tumors: A Systematic Review and Meta-analysis

Background: Albumin and globulin are main components of serum protein. The level of albumin and globulin partially represents the nutrition status and immune system. Albumin-to-globulin ratio (AGR) has been reported as a prognostic factor in various cancers. We therefore performed a meta-analysis to elucidate the prognosis effect of AGR on survival outcomes in solid tumors. Method: Six electronic database were searched for the relevant articles that assessing the prognostic value of pre-treatment AGR in solid tumor patients. The primary outcome was overall survival (OS) and the secondary outcomes were cancer-specific survival (CSS), disease-free survival (DFS) and disease-metastasis-free survival (DMFS). The time-to-event outcomes were summarized in hazard ratio (HR) and 95% confidence interval (CI). Result: A total of 13890 solid tumor patients in 24 studies were included. The AGR higher than the cut-off values ranging from 1.15-1.75 was related to better OS (HR=0.58, 95%CI 0.537-0.626, p<0.0001), CSS (HR=0.287, 95%CI 0.187-0.438, p<0.0001), DFS (HR=0.792, 95%CI 0.715-0.878, p<0.0001) and DMFS (HR=0.595, 95%CI 0.447-0.792, p<0.0001). According to the cut-off values, subgroup analysis showed that AGR had significant prognostic effect on OS in each cut-off intervals (≤1.20, 1.20-1.40 and ≥1.40). Conclusion: Pre-treatment AGR is an effective prognostic factor and high AGR represents an ideal clinical outcome in the solid tumor patients.

Prediction of potential for organ donation after circulatory death in neurocritical patients

BACKGROUND

The success or failure of donation after circulatory death depends largely on the functional warm ischemia time, which is closely related to the duration between withdrawal of life-sustaining treatment and circulatory arrest. However, a reliable predictive model for the duration is absent. We aimed to compare the performance of the Chinese Donation after Circulatory Death Nomogram (C-DCD-Nomogram) and 3 other tools in a cohort of potential donors.

METHODS

In this prospective, multicenter, observational study, data were obtained from 219 consecutive neurocritical patients in China. The patients were followed until circulatory death after withdrawal of life-sustaining treatment.

RESULTS

The C-DCD-Nomogram performed well in predicting patient death within 30, 60, 120 and 240 minutes after withdrawal of life-sustaining treatment with c-statistics of 0.87, 0.88, 0.86 and 0.95, respectively. The DCD-N score was a poor predictor of death within 30, 60 and 240 minutes, with c-statistics of 0.63, 0.69 and 0.59, respectively, although it was able to predict patient death within 120 minutes, with a c-statistic of 0.73. Neither the University of Wisconsin DCD evaluation tool (UWDCD) nor the United Network for Organ Sharing (UNOS) criteria was able to predict patient death within 30, 60, 120 and 240 minutes after withdrawal of life-sustaining treatment (UWDCD tool: 0.48, 0.45, 0.49 and 0.57; UNOS criteria: 0.50, 0.53, 0.51 and 0.63).

CONCLUSION

The C-DCD-Nomogram is superior to the other 3 tools for predicting death within a limited duration after withdrawal of life-sustaining treatment in Chinese neurocritical patients. Thus, it appears to be a reliable tool identifying potential donors after circulatory death.

Immune efficacy of an adenoviral vector-based swine influenza vaccine against antigenically distinct H1N1 strains in mice

Avian-like H1N1 swine influenza viruses are prevalent in pigs and have occasionally crossed the species barrier and infected humans, which highlights the importance of preventing swine influenza. Human adenovirus serotype 5 (Ad5) has been tested in human influenza vaccine clinical trials and has exhibited a reliable safety profile. Here, we generated a replication-defective, recombinant adenovirus (designated as rAd5-avH1HA) expressing the hemagglutinin gene of an avian-like H1N1 virus (A/swine/Zhejiang/199/2013, ZJ/199/13). Using a BALB/c mouse model, we showed that a two-dose intramuscular administration of recombinant rAd5-avH1HA induced high levels of hemagglutination inhibition antibodies and prevented homologous and heterologous H1N1 virus-induced weight loss, as well as viral replication in the nasal turbinates and lungs of mice. Furthermore, a prime-boost immunization strategy trial with a recombinant plasmid (designated as pCAGGS-HA) followed by rAd5-avH1HA vaccine provided effective protection against homologous and heterologous H1N1 virus infection in mice. These results indicate that rAd5-avH1HA is an efficacious genetically engineered vaccine candidate against H1N1 swine influenza. Future studies should examine its immune efficacy in pigs.

A meta-analysis of video-assisted thoracoscopic decortication versus open thoracotomy decortication for patients with empyema

BACKGROUND

Thoracic pleural empyema is a collection of pus within a thoracic cavity. In stage 2 (fibrinopurulent) and stage 3 (organizational), decortication is the only choice. But there is no consensus on whether to choose video-assisted thoracoscopic decortication (VATD) or open thoracotomy decortication (OTD). We sought to answer this question by performing a meta-analysis.

METHOD

Six electronic databases were searched. Primary outcomes were operative time, postoperative hospital stay, prolonged air leak, chest tube duration, relapse rate, morbidity and mortality. Review Manager (RevMan) [Computer program]. Version 5.2, 2014 was used to pool the data. Subgroup analysis and publication bias analysis were also conducted.

RESULT

The operative time [mean difference -36.89; 95% confidence interval (CI), -60.96 to -12.82; P=0.003], postoperative hospital stay (mean difference -2.41; 95% CI, -3.74 to -1.09; P=0.0004), prolonged air leak (9.7% vs. 17.1%; RR 0.56; 95% CI, 0.33 to 0.94; P=0.03), chest tube duration (mean difference -1.52; 95% CI, -2.55 to -0.48; P=0.004), morbidity (16.4% vs. 24.5%; RR 0.62; 95% CI, 0.44 to 0.88; P=0.007) and mortality (4.1% vs. 6.2%; RR 0.47; 95% CI, 0.26 to 0.86; P=0.01) of VATD were statistically less than the OTD. In terms of relapse rate, there was no statistical significance between two surgical approaches (7.2% vs. 4.2%; RRN1.28; 95% CI, 0.39 to 4.15; P=0.68).

CONCLUSIONS

The present study summarized and compared the clinical outcomes of VATD versus OTD for the empyema patients. The current data showed that VATD might be comparable or even better than OTD in terms of operative time, postoperative hospital stay, chest tube duration, prolonged air leak rate, morbidity and mortality. But referring to the relapse rate, there was no statistical significance. The results from analysis was subject bias because of prospective randomized studies were not selected. However, VATD could be implemented safely as first-line management for most of empyema.

Abstract 5383: Non-invasive diagnosis of early-stage lung cancer via targeted high-throughput DNA methylation sequencing of circulating tumor DNA (ctDNA)

Current state-of-the-art lung cancer early screening involves using low-dose CT scan to identify lung nodules smaller than 3cm in diameter. However, it’s still a clinical dilemma to differentiate between malignant and benign nodules.

We took the approach of methylation profiling by high-throughput bisulfite DNA sequencing in tissue samples to identify specific methylation signatures. We learned methylation patterns that differentiate malignant vs. benign lesions from tissue samples by in-depth data mining, and then used pattern matching to classify plasma samples. Given the usual low amount of ctDNA in plasma, we also developed an ultra-sensitive library preparation method to perform targeted bisulfite DNA sequencing from as low as 1ng of cfDNA or 1mL of plasma.

From a training set of 88 tissue samples, which includes 60 malignant specimens with different subtypes (invasive adenomas, IA; minimally invasive adenomas, MIA; atypical adenomatous hyperplasia, AAH; adenocarcinoma in situ, AIS; carcinoid; lymphoepithelioma-like carcinoma of the lung, LELC; squamous carcinoma, SC; as well as 28 benign specimens in different categories including hematomas, granuloma, tuberculosis, inflammatory pseudotumor (IPT), sclerosing hemangiomas (SHL) and infections, we were able to achieve a sensitivity of 95% for identification of malignant lesions, with a specificity of 78.6%. From an independent validation set of 45 plasma samples, we achieved a sensitivity of 94.7% and a specificity of 85.7% for differentiating patients with malignant tumor from patients with benign lesions. Specifically, our assay is demonstrated to be highly sensitive towards early-stage lung cancer detection, with a sensitivity of 93.3% in a total of 15 patients with stage IA/B lung cancer.

In summary, we have developed a highly sensitive blood-based non-invasive diagnostic assay for identification of early stage lung cancer, which can aid clinical decisions for patients with a CT scan positive for lung nodules. This approach can also be extended to non-invasive early screening for various cancer types.

Citation Format: Xuyu Cai, Yangbin Gao, Hui Shen, Peter Laird, Jian-bing Fan, Weihong Xu, Wenhua Liang, Jianxing He. Non-invasive diagnosis of early-stage lung cancer via targeted high-throughput DNA methylation sequencing of circulating tumor DNA (ctDNA) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5383. doi:10.1158/1538-7445.AM2017-5383

A nomogram for predicting post-operative cancer specific survival in AJCC 8th edition stage I NSCLC patients

8540

Background: The AJCC 8th edition staging system has moved 4-5 cm 7th edition stage Ib NSCLC to current stage IIa, thus theoretically all current stage I patients are not considered candidates for adjuvant therapy (ad-Tx). This study was to develop a clinical nomogram for predicting cancer specific survival (CSS) of the current stage I resected NSCLC to identify those with higher risk for cancer-related deaths and potentially benefiting from ad-Tx. Methods: NSCLC cases between 1998 and 2013 was extracted from the SEER database and were randomly divided into training (n = 23,496) and validation (n = 7,915) cohorts. We identified and integrated the recurrence-associated factors to build a nomogram. The model was subjected to bootstrap internal validation and independent validation. The predictive accuracy and discriminative ability were illustrated by calibration plots and concordance index (C-index). We determined the cut-off for high-risk group by matching the nomogram-predicted 5-year CSS with that of the current 4-5 cm stage IIa cases. Results: In multivariate analysis, independent factors for CSS were examined lymph node count ( < 16 vs. > = 16), tumor size, resection scope (lobectomy/segmentectomy/wedge resection), differentiation grade, histology (squamous vs. non-squamous vs. former BAC with majority being AIS/MIA) and visceral pleural invasion, which were then integrated into the model (sex and age were not included due to lack of direction to ad-Tx selection). The calibration curves showed excellent agreement between nomogram prediction and actual observation. The C-index of the nomogram was higher than that of staging system (Ia1, Ia2, Ia3, Ib) (training set, 0.60 vs. 0.56, P < 0.01; validation set, 0.60 vs. 0.57, P < 0.01). Specifically, 21.5% stage Ib patients (8.8% of all stage I) were categorized into high risk group (score > 29.5) and had inferior CSS compared with 4-5 cm stage IIa patients. Conclusions: We established a nomogram that can individually predict CSS for 8th edition stage I NSCLC. By this model, we identified a subset of patients with relatively high risk for recurrence. Further study to determine the impact of postoperative ad-Tx on these high risk patients is undergoing.

Esophageal cancer in elderly patients: A population-based study

e15561

Background: As the aging issue and increased elderly esophageal cancer (EC) patients, we sought to study the clinical characteristics, treatment modality and outcomes of EC patients 70 years or older compared with those younger than 70 years old. Methods: The national Surveillance, Epidemiology, and End Results (SEER) database for the period from 1973 to 2013 was analyzed. The patient and treatment characteristics were compared between the age groups. Multivariate Cox proportional hazard regression analyses were also performed to identify independent prognostic factors. Propensity-score matching analyses (PSA) regarding survival after different treatments were also performed in locoregional EC . Results: Of 61,799 eligible patients, 24,046 patients (38.9%) were 70 years or older and 37,753 patients (61.1%) were younger than 70 years. Compared with the younger group, patients 70 years or older were characterized by having a higher proportion of patients with female gender, white race, localized disease, non-ademocarcinoma and without any treatment, as well as inferior overall survival (HR, 1.324) and EC-specific survival (HR, 1.270). In addition, older patients shared same independent prognostic factors with younger patients, including age, histology and race. Specifically, compared with those receiving no intensive treatments, surgery alone (HR, 0.342), both surgery and RT (HR, 0.323) and RT only (HR, 0.525) were favorable among elderly patients, as confirmed by both multivariate adjustment and PSA. Conclusions: Compared to younger EC patients, those 70 years or older showed distinctive clinical characteristics and inferior survival. Despite showing a higher proportion of localized disease, patients 70 years or older were less likely to be subjected to surgery or/and RT. Thus, the role of intensive treatments, which were identified as favorable factors among elderly patients in this study, warrants further investigation.

Impact of Examined Lymph Node Count on Precise Staging and Long-Term Survival of Resected Non-Small-Cell Lung Cancer: A Population Study of the US SEER Database and a Chinese Multi-Institutional Registry

Purpose We investigated the correlation between the number of examined lymph nodes (ELNs) and correct staging and long-term survival in non-small-cell lung cancer (NSCLC) by using large databases and determined the minimal threshold for the ELN count. Methods Data from a Chinese multi-institutional registry and the US SEER database on stage I to IIIA resected NSCLC (2001 to 2008) were analyzed for the relationship between the ELN count and stage migration and overall survival (OS) by using multivariable models. The series of the mean positive LNs, odds ratios (ORs), and hazard ratios (HRs) were fitted with a LOWESS smoother, and the structural break points were determined by Chow test. The selected cut point was validated with the SEER 2009 cohort. Results Although the distribution of ELN count differed between the Chinese registry (n = 5,706) and the SEER database (n = 38,806; median, 15 versus seven, respectively), both cohorts exhibited significantly proportional increases from N0 to N1 and N2 disease (SEER OR, 1.038; China OR, 1.012; both P < .001) and serial improvements in OS (N0 disease: SEER HR, 0.986; China HR, 0.981; both P < .001; N1 and N2 disease: SEER HR, 0.989; China HR, 0.984; both P < .001) as the ELN count increased after controlling for confounders. Cut point analysis showed a threshold ELN count of 16 in patients with declared node-negative disease, which were examined in the derivation cohorts (SEER 2001 to 2008 HR, 0.830; China HR, 0.738) and validated in the SEER 2009 cohort (HR, 0.837). Conclusion A greater number of ELNs is associated with more-accurate node staging and better long-term survival of resected NSCLC. We recommend 16 ELNs as the cut point for evaluating the quality of LN examination or prognostic stratification postoperatively for patients with declared node-negative disease.

Nomogram prediction for the survival of the patients with small cell lung cancer

BACKGROUND

Small cell lung cancer (SCLC) is a subtype of lung cancer with poor prognosis. In this study, we aimed to build a nomogram to predict the survival of individual with SCLC by incorporating significant clinical parameters.

METHODS

The patients with SCLC were enrolled from the First Affiliated Hospital of Guangzhou Medical University (GMUFAH) between 2009 and 2013. We identified and incorporated the independent prognostic factors to build a nomogram to predict the survival of SCLC patients. The predictive accuracy and discriminative ability of the nomogram were evaluated by concordance index (C-index) and calibration curve. We also compared the accuracy of the built model with the 7^th AJCC TNM and VALSG staging system. The nomogram was further validated in an independent cohort of 80 patients with SCLC from Cancer Center of Guangzhou Medical University (GMUCC) between 2009 and 2013.

RESULTS

A total of 275 patients with SCLC were included in the primary cohort, and seven independent prognostic factors were identified including age, N stage, metastasis status, histology, platelets to lymphocyte ratio (PLR), neuron specific enolase (NSE) and CYFRA21-1 as independent prognostic factors after using Cox regression model. A nomogram incorporating these prognostic factors was subsequently built. The calibration curves for possibilities of 1-, 2-year overall survival (OS) revealed optimal agreement between nomogram prediction and actual observation. The C-index of this nomogram was higher than that of TNM and VALSG staging system in both primary and validation cohort (nomogram vs. TNM, primary cohort 0.68 vs. 0.65, P<0.01, validation cohort 0.66 vs. 0.62, P<0.05; nomogram vs. VALSG, primary cohort 0.68 vs. 0.66, P<0.01, validation cohort 0.66 vs. 0.64, P<0.05).

CONCLUSIONS

In this study, we established and validated a novel nomogram for the prediction of OS for the patients with SCLC. This model could provide more accurate individual prediction of survival probability of SCLC than the existing staging systems.

[Experimental study on the immune response of fusion tumor vaccine of HepG2 and dendritic cells in vitro]

Objective: To estimate the immune response of HepG2/dendritic cell (DC) fusion cells vaccines against HepG2 cells in vitro. Methods: Peripheral blood mononuclear cells (PBMCs) were isolated from healthy donors by Ficoll-Hypaque density-gradient centrifugation.Then DC were obtain from PBMCs by culturing in medium containing granulocyte macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4) for 5 days.DC and HepG2 fusion cells were induced by polythyleneglycol (PEG). The fusion cells were examined under fluorescence microscope by labeling DCs and HepG2 with green and red fluorescein, respectively, and then the fusion rates were analyzed by flow cytometry.The capacity of fusion cells to secrete interleukin (IL)-12 and stimulate the proliferation of T lymphocyte was assessed by ELISA and Flow cytometry, respectively.ELISPOT was used to assess the interferon gamma (IFN-γ) produced by cytotoxicity T lymphocyte (CTL), and the specific killing ability of fusion cells induce-CTL targeting HepG2 was estimated. Results: The fusion rate of HepG2/DC was 54.5%, and the fusion cells expressed a higher levels of DC mature marker CD80 and costimulatory molecules CD83, CD86 and MHC-Ⅰ, MHC-Ⅱ molecules HLA-ABC and HLA-DR than those in immature DCs (P<0.01). HepG2/DC showed a greater capacity to secrete high level of IL-12 (P<0.05) and activate proliferation of lymphocytes in vitro, as compared with DCs alone and DCs mix HepG2 (P<0.01). The HepG2/DC -activated CTL generated higher IFN-γ level and had a specific killing ability against HepG2 cells at the effecter/target ratio 30∶1 (31.4%±2.4%) and 100∶1 (57.6%±7.3%) (P<0.01). Conclusions: HepG2/DC fusion cells could efficiently stimulate T lymphocytes to generate specific CTL targeting HepG2 cells.It might be a promising strategy of immunotherapy for HCC.

Distance travelled to purchase alcohol and the mediating effect of price

OBJECTIVES

Little research has been done into the distance travelled by consumers to purchase alcohol, whether this is influenced by demographic characteristics or drinking levels of consumers, and the effect of price on purchase distance. This study aimed to explore distances drinkers were prepared to travel to purchase alcohol at on- and off-site outlets and how these decisions were affected by price discounting.

STUDY DESIGN

Online survey.

METHODS

The study, including 831 alcohol consumers aged 18 years and older living in Australian capital cities, was undertaken in 2012. The survey was used to gather data on the distances which participants anticipated that they usually travelled to purchase alcohol. The data provided insight into which factors influence where participants would choose to purchase alcohol and the possible effects of price discounts on purchase distance.

RESULTS

Most participants would choose to travel less than 10 km to purchase alcohol. Data indicated that price discounting might increase the purchase distance that most participants would be prepared to travel to purchase alcohol; this was more marked regarding off-site outlets and among high-risk drinking groups including young males and participants with risky drinking levels.

CONCLUSIONS

Price discounting affects hypothetical purchase distance choices, indicating the importance of price when implementing alcohol control policies. Purchase distance might be more affected by price discounting among consumers visiting off-site outlets, but less useful when exploring associations with on-site outlets.

Molecular and pathological evaluation of cryopreserved colorectal cancerous tissues: Effects of freezing method and cryoprotection

BACKGROUND

Snap freezing and RNAlater stabilization are methods that were wildly used in biospecimen depositories to preserve cancer tissues. Both methods have its own limitations. An ideal method for preservation of diseased tissues should permit the broader uses of stored tissue samples, including not just for molecular diagnostic analysis, histopathological evaluation, but also for the recovery of functional live cells and tissues as well as the regeneration of patient-derived xenograft (PDX) models for the drug screening study.

MATERIALS AND METHODS

This study investigated molecular and pathological evaluation of cryopreserved colorectal cancer tissues, with an emphasis on effects of freezing method and cryoprotection. Global gene expression analysis with microarrays and histological examination of tissue samples were performed to compare tissue specimens after snap freezing, cryoprotectant permeation and subsequent cryopreservation.

RESULTS

Compared with the fresh tissue samples (immediately stabilized in RNAlater after collection), samples preserved by snap freezing exhibited the largest number of differentially-expressed genes. Some genes relate to neuron, drug addiction and drug binding, but the rest of differentially-expressed genes were functionally dispersive. Cryoprotectant permeation into tissue samples and subsequent cryopreservation via a rate-controlled freezing resulted in much less differentially expressed genes. Histological structures of tissue specimens were both well preserved by snap freezing and cryoproservation.

CONCLUSION

Snap freezing may not be as reliable as commonly considered. The pilot study demonstrates the feasibility of using cryopreservation to retain viable diseased tissues for multiple applications.

Multi-functional thermo-crosslinkable collagen-metal nanoparticle composites for tissue regeneration: nanosilver vs. nanogold

Collagen–silver/gold biomimetic matrices were developed for cardiac tissue engineering.

Development and validation of a nomogram for predicting the survival of patients with non-metastatic nasopharyngeal carcinoma after curative treatment

Background

The TNM staging system is far from perfect in predicting the survival of individual cancer patients because only the gross anatomy is considered. The survival rates of the patients who have the same TNM stage disease vary across a wide spectrum. This study aimed to develop a nomogram that incorporates other clinicopathologic factors for predicting the overall survival (OS) of non-metastatic nasopharyngeal carcinoma (NPC) patients after curative treatments.

Methods

We retrospectively collected the clinical data of 1520 NPC patients who were diagnosed histologically between November 2000 and September 2003. The clinical data of a separate cohort of 464 patients who received intensity-modulated radiation therapy (IMRT) between 2001 and 2010 were also retrieved to examine the extensibility of the model. Cox regression analysis was used to identify the prognostic factors for building the nomogram. The predictive accuracy and discriminative ability were measured using the concordance index (c-index).

Results

We identified and incorporated 12 independent clinical factors into the nomogram. The calibration curves showed that the prediction of OS was in good agreement with the actual observation in the internal validation set and IMRT cohort. The c-index of the nomogram was statistically higher than that of the 7th edition TNM staging system for predicting the survival in both the primary cohort (0.69 vs. 0.62) and the IMRT cohort (0.67 vs. 0.63).

Conclusion

We developed and validated a novel nomogram that outperformed the TNM staging system in predicting the OS of non-metastatic NPC patients who underwent curative therapy.

White light, autofluorescence and narrow-band imaging bronchoscopy for diagnosing airway pre-cancerous and early cancer lesions: a systematic review and meta-analysis

BACKGROUND

We aimed to summarize the diagnostic accuracy of white light bronchoscopy (WLB) and advanced techniques for airway pre-cancerous lesions and early cancer, such as autofluorescence bronchoscopy (AFB), AFB combined with WLB (AFB + WLB) and narrow-band imaging (NBI) bronchoscopy.

METHODS

We searched for eligible studies in seven electronic databases from their date of inception to Mar 20, 2015. In eligible studies, detected lesions should be confirmed by histopathology. We extracted and calculated the 2×2 data based on the pathological criteria of lung tumor, including high-grade lesions from moderate dysplasia (MOD) to invasive carcinoma (INV). Random-effect model was used to pool sensitivity, specificity, diagnostic odds ratio (DOR) and the area under the receiver-operating characteristic curve (AUC).

RESULTS

In 53 eligible studies (39 WLB, 39 AFB, 17 AFB + WLB, 6 NBI), diagnostic performance for high-grade lesions was analyzed based on twelve studies (10 WLB, 7 AFB, 7 AFB + WLB, 1 NBI), involving with totally 2,880 patients and 8,830 biopsy specimens. The sensitivity, specificity, DOR and AUC of WLB were 51% (95% CI, 34-68%), 86% (95% CI, 73-84%), 6 (95% CI, 3-13) and 77% (95% CI, 73-81%). Those of AFB and AFB + WLB were 93% (95% CI, 77-98%) and 86% (95% CI, 75-97%), 52% (95% CI, 37-67%) and 71% (95% CI, 56-87%), 15 (95% CI, 4-57) and 16 (95% CI, 6-41), and 76% (95% CI, 72-79%) and 82% (95% CI, 78-85%), respectively. NBI presented 100% sensitivity and 43% specificity.

CONCLUSIONS

With higher sensitivity, advanced bronchoscopy could be valuable to avoid missed diagnosis. Combining strategy of AFB and WLB may contribute preferable diagnosis rather than their alone use for high-grade lesions. Studies of NBI warrants further investigation for precancerous lesions.

[Analysis of HPA1-16 and HLA-A, B gene polymorphisms among ethnic Han population from Shandong]

OBJECTIVE

To study the polymorphisms of human platelet antigen (HPA) 1-16 and human leukocyte antigen (HLA)-A and -B loci among ethnic Han population from Shandong.

METHODS

A total of 588 samples from platelet donors were genotyped for the above loci with sequence-specific primer PCR and sequence-specific oligonucleotide probe PCR.

RESULTS

The frequencies of HPA-la, -1b, HPA-2a, -2b, HPA-3a, -3b, HPA-4a, -4b, HPA-5a, -5b, HPA-6a, -6b, HPA-15a, -15b were 0.9974, 0.0026, 0.9456, 0.0544, 0.5417, 0.4583, 0.9983, 0.0017, 0.9889, 0.0111, 0.9903, 0.0097, 0.5434 and 0.4583, respectively. The HPA-7-14 and HPA-16 showed no heterozygosity as the b allele was not detected in such loci. The most common genotypic combination for HPA was HPA-(1,4,7-14,16,17) aa-2aa-3ab-5aa -6aa-15ab (0.1820). HLA-A2 (0.3070) and HLA-B13 (0.1361) demonstrated the highest frequencies at their respective loci.

CONCLUSION

The HPA and HLA loci are highly polymorphic among ethnic Hans from Shandong. The distribution of HPA polymorphisms also shows a great ethnic and territorial difference. It is important to construct regional database for the genotypes of HPA and HLA loci for platelet donors.