Archives of Oral Biology
Volume 152,
August 2023
, 105735
Author links open overlay panel, , , ,
Abstract
Objective
To build a prognostic model for oral squamous cell carcinoma patients with type 2 diabetes mellitus.
Design
Oral squamous cell carcinoma patients with type 2 diabetes mellitus in Xiangya Hospital were studied. Patients during January 2011 to January 2015 were included in training set (n=146), and those during January 2017 to December 2020 were included in test set (n=81). Univariate and multivariate Cox regressions were used to screen independent prognostic variables. Nomogram was used to show the model. C-index, internal bootstrap resampling and external validation were used to evaluate the model.
Results
Six independent prognostic factors (T stage, N stage, pathological grade, metformin use, sulfonylureas use, and fasting blood glucose) were screened from training set. Based on the six variables, nomogram was constructed to predict the prognosis of oral squamous cell carcinoma patients with type 2 diabetes mellitus. C-index value was 0.728, and result of internal bootstrap resampling showed better prediction efficiency for one-year survival. All patients were divided into two groups according to total points calculated based on the model. Group with low total points experienced better survival than that with high total points both in training set and test set.
Conclusions
The model provides a relatively accurate method to predict the prognosis of oral squamous cell carcinoma patients with type 2 diabetes mellitus.
Introduction
Oral squamous cell carcinoma (OSCC), the most common type of oral cancer, accounts for 90% of all cancer types in oral cavity (Warnakulasuriya, 2009). In the past several years, new cases of oral cancer have been growing rapidly. According to the global cancer statistic, the number of new cases of 2020 is 22,849 more than that of 2018 (Bray et al., 2018; Sung et al., 2021). Patients diagnosed with early stage of OSCC usually experience a better 5-year survival rate (90%), while the 5-year survival rate of those diagnosed with later stage drops sharply to 30% (Omar, 2015). Researchers have developed many tools to predict the survival of OSCC patients. The most well-known one to us is the TNM staging system(Moeckelmann et al., 2018). According to the size of primary tumor, lymph node metastasis and distant metastasis, the prognosis of patients with OSCC can be preliminarily predicted. However, some other clinical factors can also affect the prognosis of patients with OSCC. Wang et al. constructed a prognostic model of OSCC based on clinicopathological data including age, sex, site, race, origin, grade, surgery, radiation and TNM stage (Wang et al., 2018). Nomograms of the model allowed clinicians to predict the long-term survival rate of OSCC patients more accurately.
Type 2 diabetes mellitus (T2DM), a complex chronic systemic disease, is charactered by insulin resistance and deficiency in insulin secretion, accounting for 95% diabetes mellitus patients(Xu et al., 2018). According to the prediction of the International Diabetes Federation (IDF), the population of diabetic patients will grow from 382 million in 2013–592million in 2035 by 55% (Shi & Hu, 2014). T2DM is closely related to the occurrence and development of various oral diseases. It was reported that T2DM and periodontitis could promote each other, T2DM could increase the risk of periodontitis by 34%, and the prevalence of T2DM was significantly higher in periodontitis patients(Wu et al., 2020). Some infectious diseases, such as oral candidiasis, could also be secondary to uncontrolled T2DM(Sampath et al., 2019). Diabetes is also closely related to OSCC. Referring to the statistics of Xiangya Hospital in China, OSCC patients accompanying with T2DM account for 14.3% of all OSCC patients (Hu et al., 2020). Predictably, this proportion will continue to increase as the number of people with T2DM increases. In our previous study, type 2 diabetes mellitus (T2DM) was an independent risk factor for OSCC patients (Hu et al., 2020). Thus, OSCC patients with T2DM a special population with unique prognostic characteristics. However, up to now, there has not been a prognostic model for OSCC patients with T2DM.
In this study, we aimed to construct a model that could predict the prognosis of OSCC patients with T2DM. The model will allow clinicians to relatively accurately predict the prognosis of patients based on their clinical and pathological characteristics, thereby assisting in determining treatment plans.
Section snippets
Patients
The training cohort of OSCC patients with T2DM during January 2011 to January 2015 of Xiangya Hospital presented in previous study were used to construct the prognostic model (Hu et al., 2020). Study design, sample size calculation, inclusion and exclusion criteria had been described in detail previously. OSCC patients diagnosed with T2DM in their past history and final diagnosis were included in this study. Squamous cell carcinoma located at “tongue”, “buccal mucosa”, “gingiva”, “floor of the
Summary Statistics
In total, 146 OSCC patients with T2DM were used to construct the prognostic model. The follow-up time ranged from the lowest 10 days to the highest 1825 days, with a mean follow up of 1186.82 days (standard error, 62.25). Among all variables, missing values were found in 8 variables including urban and rural residence (2.1%), education level (9.6%), tobacco use (0.7%), alcohol consumption (2.1%), betel quid chewing (2.1%), pathological grade (6.2%), fasting blood glucose (8.2%) and HbA1c
Discussion
T2DM and cancer are becoming increasingly prevalent all over the world. More and more studies show that T2DM can increase the incidence rate of cancer(Shlomai et al., 2016). In T2DM patients, the prevalence of oral cancer was 0.25%, and patients with oral cancer combined with diabetes mellitus experienced a higher mortality than controls(Ramos-Garcia et al., 2021). A comparative study in Taiwan, China, conducted by Tseng CH, showed that metformin could decrease oral cancer risk in patients with
Conclusions
In conclusion, we constructed a prognostic model for predicting the prognosis of OSCC patients with T2DM by 6 clinicopathological factors, including T stage, N stage, pathological grade, metformin use, sulfonylureas use and fasting blood glucose level. As some controllable factors, we suggest that OSCC patients with T2DM should strictly control their blood glucose in a relatively normal range, and give priority to the metformin use to control T2DM without affecting the efficacy. Finally,
Funding
This work was supported by the National Natural Science Foundation [82170973], Project of National Center for Clinical Medical Research of Geriatrics [2021LNJJ08], and Hunan Postgraduate Scientific Research Innovation Project (key project) [CX20220118].
CRediT authorship contribution statement
Xin Hu: the conception and design of the study, acquisition of data, analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be submitted. Haofeng Xiong: acquisition of data, analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, final approval of the version to be submitted. Shiying Huang: the conception and design of the study,
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgments
None.
References (29)
- A. Almangush et al.
Staging and grading of oral squamous cell carcinoma: An update
Oral Oncology
(2020)
- S.C. Chang et al.
Hyperglycemia, tumorigenesis, and chronic inflammation
Critical Reviews in Oncology/Hematology
(2016)
- H. Chen et al.
Sulfonylurea receptor 1-expressing cancer cells induce cancer-associated fibroblasts to promote non-small cell lung cancer progression
Cancer Letters
(2022)
(Video) Oral Cancer - causes, symptoms, diagnosis, treatment, pathology - X. Hu et al.
Metformin reduces the increased risk of oral squamous cell carcinoma recurrence in patients with type 2 diabetes mellitus: A cohort study with propensity score analyses
Surgical Oncology
(2020)
- N. Moeckelmann et al.
Prognostic implications of the 8th edition American Joint Committee on Cancer (AJCC) staging system in oral cavity squamous cell carcinoma
Oral Oncology
(2018)
- S. Patil
Metformin treatment decreases the expression of cancer stem cell marker CD44 and stemness related gene expression in primary oral cancer cells
Archives of Oral Biology
(2020)
- Y. Shi et al.
The global implications of diabetes and cancer
Lancet
(2014)
- B. Thakkar et al.
Metformin and sulfonylureas in relation to cancer risk in type II diabetes patients: a meta-analysis using primary data of published studies
Metabolism
(2013)
- A. Vancura et al.
Metformin as an anticancer agent
Trends Pharmacological Science
(2018)
- S. Warnakulasuriya
Global epidemiology of oral and oropharyngeal cancer
Oral Oncology
(2009)
Metformin inhibits proliferation of oral squamous cell carcinoma cells by suppressing proteolysis of nerve growth factor receptor
Archives of Oral Biology
(2021)
Natural products for the treatment of type 2 diabetes mellitus: Pharmacology and mechanisms
Pharmacology Research
(2018)
Increased cancer-related mortality for patients with type 2 diabetes who use sulfonylureas or insulin
Diabetes Care
(2006)
Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
CA: A Cancer Journal for Clinicians
(2018)
Cited by (0)
Recommended articles (6)
Research article
Does three-dimensional intraglandular location predict malignancy in parotid tumors?
International Journal of Oral and Maxillofacial Surgery, Volume 52, Issue 3, 2023, pp. 296-303
Tumors arising within the parotid encompass a heterogeneous mix of benign and malignant neoplasms and other tissue growths. The purpose of this study was to determine the association between the location of intraparotid masses and the risk of malignancy. A retrospective cohort study was performed of patients diagnosed with parotid tumors following open tumor excision. The primary predictor variable was the location of the epicenter of the tumor in three-dimensional space, as determined from preoperative imaging. Other variables were patient demographics and clinical parameters. The primary outcome variable was the final histopathologic diagnosis of a benign or malignant process. A χ2 analysis was performed to test for any significant associations between demographic, clinical, and radiographic factors in relation to the outcome, and backwards stepwise logistic regression analysis was used to control for variables. Both increasing age (P=0.002) and the presence of local pain (P=0.020) were associated with malignancy. Tumors located anterior to the posterior border of the retromandibular vein had 2.18 times higher odds of malignancy (95% confidence interval 1.13–4.21; P=0.020). Multivariate regression analysis suggested that patient age, the presence of pain, and tumor location anterosuperiorly and superoinferiorly could all assist in determining the odds of malignancy.
Research article
An alternative way for fronto-orbito-zygomatic reconstruction in congenital malformations: A case report with 4-year follow-up
Journal of Stomatology, Oral and Maxillofacial Surgery, Volume 123, Issue 4, 2022, pp. e224-e227
Research article
Cdc42 regulates cranial suture morphogenesis and ossification
Biochemical and Biophysical Research Communications, Volume 512, Issue 2, 2019, pp. 145-149
Cdc42 (cell division cycle 42) is ubiquitously expressed small GTPases belonging to the Rho family of proteins. Previously, we generated limb bud mesenchyme-specific Cdc42 inactivated mice (Cdc42 conditional knockout mice; Cdc42 fl/fl; Prx1-Cre), which showed short limbs and cranial bone deformities, though the mechanism related to the cranium phenotype was unclear. In the present study, we investigated the role of Cdc42 in cranial bone development. Our results showed that loss of Cdc42 caused a defect of intramembranous ossification in cranial bone tissues which is related to decreased expressions of cranial suture morphogenesis genes, including Indian hedgehog (Ihh) and bone morphogenetic proteins (BMPs). These findings demonstrate that Cdc42 plays a crucial role in cranial osteogenesis, and is controlled by Ihh- and BMP-mediated signaling during cranium development.
Research article
Is a Medical Degree Associated With Faculty Leadership Position Attainment in Oral and Maxillofacial Surgery Residency Programs?
Journal of Oral and Maxillofacial Surgery, Volume 80, Issue 12, 2022, pp. 2024-2028
The decision to obtain double-degree versus single-degree training in oral and maxillofacial surgery (OMS) has been a widely debated topic in the United States over the past several decades. The purpose of this study is to determine if OMS faculty holding leadership positions (ie, program directors and chairs/chiefs) are more likely to be single-degree trained versus double-degree trained.
The authors designed a cross-sectional observational study to address the research purpose. The primary predictor variable was faculty leadership education (single-degree trained vs double-degree trained). The secondary predictor variable was accredited OMS program type led by the faculty with leadership positions (double-degree, both single-degree and double-degree, single-degree, or military program). The primary outcome variable was faculty leadership position (program director or chair/chief). Sums and percentages were calculated and Chi-squared (χ2) tests were used to compare the faculty leadership education with faculty leadership positions for each group. P values less than .05 were considered statistically significant.
The study sample was composed of 198 subjects, of which 99 subjects were identified as program directors and 99 subjects were identified as chairs/chiefs. There was no statistically significant difference between the proportions of program directors and chairs/chiefs who were single-degree trained versus double-degree trained when looking at all accredited OMS programs in the United States (52.5% vs 47.5%, P=.615 and 56.6% vs 43.4%, P=.191, respectively). However, program directors of double-degree programs were statistically significantly more likely to be double-degree trained than single-degree trained (77.1% vs 22.9%, P=.001) and program directors and chairs/chiefs of single-degree programs were statistically significantly more likely to be single-degree trained than double-degree trained (67.4% vs 32.6%, P=.022 and 65.1% vs 34.9%, P=.047, respectively).
Overall, no statistically significant difference exists between the proportions of program directors and chairs/chiefs that were single-degree trained versus double-degree trained at accredited OMS programs. However, when stratifying programs by program type, program directors of double-degree programs were statistically significantly more likely to be double-degree trained and program directors and chairs/chiefs of single-degree programs were statistically significantly more likely to be single-degree trained.
(Video) Understanding Oral Squamous Cell Carcinoma or Oral CancerResearch article
RELAXIN enhances differentiation and matrix mineralization through Relaxin/insulin-like family peptide receptor 2 (Rxfp2) in MC3T3-E1 cells in vitro
Bone, Volume 65, 2014, pp. 92-101
RELAXIN (RLN) is a polypeptide hormone of the insulin-like hormone family; it facilitates birth by softening and widening the pubic symphysis and cervix in many mammals, including humans. The role of RLN in bone metabolism was recently suggested by its ability to induce osteoclastogenesis and activate osteoclast function. RLN binds to RELAXIN/INSULIN-LIKE FAMILY PEPTIDE 1 (RXFP1) and 2 (RXFP2), with varying species-specific affinities. Young men with mutated RXFP2 are at high risk for osteoporosis, as RXFP2 influences osteoblast metabolism by binding to INSULIN-LIKE PEPTIDE 3 (INSL3). However, there have been no reports on RLN function in osteoblast differentiation and mineralization or on the functionally dominant receptors for RLN in osteoblasts. We previously described Rxfp1 and 2 expression patterns in developing mouse oral components, including the maxillary and mandibular bones, Meckel's cartilage, tongue, and tooth primordia. We hypothesized that Rln/Rxfp signaling is a key mediator of skeletal development and metabolism. Here, we present the gene expression patterns of Rxfp1 and 2 in developing mouse calvarial frontal bones as determined by in situ hybridization. In addition, RLN enhanced osteoblastic differentiation and caused abnormal mineralization and extracellular matrix metabolism through Rxfp2, which was predominant over Rxfp1 in MC3T3-E1 mouse calvarial osteoblasts. Our data suggest a novel role for Rln in craniofacial skeletal development and metabolism through Rxfp2.
Research article
Nuclear import of transcriptional corepressor BCOR occurs through interaction with karyopherin α expressed in human periodontal ligament
Biochemical and Biophysical Research Communications, Volume 507, Issues 1–4, 2018, pp. 67-73
Mutations in the gene encoding BCL-6 corepressor (BCOR) are responsible for oculofaciocardiodental (OFCD) syndrome, which is a rare X-linked dominant disorder characterized by radiculomegaly of permanent teeth as the most typical symptom. To function as a transcriptional corepressor, BCOR needs to enter the nucleus; however, the molecular pathway for its nuclear translocation during dental root formation remains unclear. The purpose of this study was to determine the mechanism underlying BCOR transport into the nucleus. Our results showed that human periodontal ligament (PDL) cells expressed karyopherin α (KPNA)2, KPNA4, and KPNA6 belonging to a family of nuclear import proteins, which interacted with BCOR in the immunoprecipitation assay. Site-directed mutagenesis targeting the two nuclear localization signals (NLSs) within BCOR reduced its nuclear translocation; however, co-expression of KPNA2, KPNA4, or KPNA6 with BCOR carrying a previously described mutation which eliminated one of the two NLSs significantly increased nuclear accumulation of the mutant BCOR, indicating participation of KPNA in BCOR nuclear translocation. Comparative expression profiling of PDL cells isolated from normal and OFCD patients revealed significant downregulation of SMAD4, GLI1, and nuclear factor 1-C (NFIC) mRNA expression, suggesting that BCOR mutations cause hyperactive root formation in OFCD syndrome by inhibiting SMAD4-Hedgehog-NFIC signaling implicated in dental root development. Our study contributes to understanding of the mechanisms providing nuclear import of BCOR during root formation.
- 1
ORCID: 0000-0003-1430-0672
- 2
ORCID: 0000-0002-3213-4041
- 3
ORCID: 0009-0007-5200-7932
- 4
ORCID: 0000-0002-5257-0051
(Video) Oral squamous cell carcinoma : Basics
- 5
ORCID: 0000-0001-7466-3999
© 2023 Elsevier Ltd. All rights reserved.
FAQs
What is the most important prognostic factor in oral squamous cell carcinoma? ›
The presence of neck metastases is the most important prognostic factor for oral SCC; if present, there is a 50% reduction in survival rates.
What is the prognosis for oral squamous cell carcinoma? ›Prognosis for Oral Squamous Cell Carcinoma
For localized carcinoma of the floor of the mouth, 5-year survival is 75%. Lymph node metastasis decreases survival rate by about half. Metastases reach the regional lymph nodes first and later the lungs. For lower lip lesions, 5-year survival is 90%, and metastases are rare.
Tumor expression of miR-448 is a prognostic marker in oral squamous cell carcinoma | BMC Cancer | Full Text.
What is the prognostic significance of Ki 67 positivity in oral squamous cell carcinoma? ›The Ki-67 expression is significantly higher in tissues with moderately –differentiated or poorly differentiated squamous cell carcinoma and moderate or severe Oral epithelial dysplasia and provides an objective criterion for determining the severity of OED and histological grading of OSCC.
Which squamous cell carcinoma has best prognosis? ›Patients with stage I, II, or III cancer have the best survival, whereas patients with stage IV or recurrent cancer who are older than 66.5 years have the worst survival. Patients with stage IV or recurrent cancer who are younger than 66.5 years have intermediate survival.
What are the prognostic factors influencing the survival difference of oral tongue squamous cell carcinoma? ›For oral tongue squamous cell carcinoma, radiotherapy was a good prognostic factor. On the contrary, a tumor with large vertical size, closed surgical margin, poor histologic grade, and radical neck dissection in the operated group were poor prognostic factors.
How many years does it take for squamous cell carcinoma to spread? ›Metastasis of cutaneous squamous cell carcinoma (cSCC) is rare. However, certain tumor and patient characteristics increase the risk of metastasis. Prior studies have demonstrated metastasis rates of 3-9%, occurring, on average, one to two years after initial diagnosis [6].
What is the prognosis for stage 4 squamous cell carcinoma? ›The 5-year survival is 99 percent when detected early. Once SCC has spread to the lymph nodes and beyond, the survival rates are lower. Yet this cancer is still treatable with surgery and other therapies, even in its advanced stages.
What is Stage 2 squamous cell carcinoma of the oral cavity? ›Stage II: The tumor is 2 cm or smaller, and the depth of invasion is between 5 and 10 mm. Or, the tumor is larger than 2 cm but not larger than 4 cm, and the depth of invasion is 10 mm or less. The cancer has not spread to lymph nodes or other parts of the body (T2, N0, M0).
What are examples of prognostic markers? ›Examples of prognostic biomarkers are PSA level at the time of a prostate cancer diagnosis or the PIK3CA mutation status of tumors in women with human epidermal growth factor receptor 2 (HER2) –positive metastatic breast cancer.
What are the prognostic indicators? ›
A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease or the chance of the disease recurring (coming back).
What is a good prognostic marker? ›Prognostic markers are biomarkers used to measure the progress of a disease in the patient sample. Prognostic markers are useful to stratify the patients into groups, guiding towards precise medicine discovery. The widely used prognostic markers in cancers include stage, size, grade, node and metastasis.
What is p16 prognostic significance? ›In vaginal cancer, p16 is able to identify HPV-positive cancers with 96% sensitivity (96%) and (85.7%) specificity 9; however, the role of p16 expression as a marker for survival in vaginal cancer is unclear.
What are prognostic markers of metastasis? ›“T” represents tumor size, “N” indicates the number of lymph nodes that the cancer has spread to, and “M” conveys the presence of distant metastasis [11]. In the absence of distant metastasis (“M”), tumor size and lymph node status are established prognostic markers for likelihood of metastasis.
What is p16 positivity in oral squamous cell carcinoma? ›Background: p16 expression is well-established in oropharyngeal squamous cell carcinoma as a surrogate marker of HPV infection, and is associated with favourable prognosis.
What is the survival rate for p16 positive squamous cell carcinoma? ›P16 positivity is associated with significantly higher survival and a significantly decreased risk for tumor recurrence; the 5-year overall survival rates for patients with p16-positive tumors were 88% vs 61% for p16-negative patients.
What is the most aggressive variant of squamous cell carcinoma? ›Basaloid SCC is a high-grade SCC variant with small cells arranged in a palisaded architecture, with hyperchromatic nuclei and only focal areas of squamous differentia- tion.
What is the prognosis for Stage 3 squamous cell carcinoma? ›Squamous cell carcinoma is considered curable when caught early. Stage 3 skin cancer has spread to nearby tissues and lymph nodes and, thus, is more difficult to treat. This type of cancer is treatable with surgery and other treatment options, like chemotherapy and radiation therapy.
What is the most common primary site of metastasis of oral squamous cell carcinoma? ›The most common site for OSCC metastasis is cervical lymph nodes, and it reduces the survival rate by 50% 13, 14. Cancer cells usually spread to the lymph nodes on the same side of the cancer primary site. However, contralateral or bilateral lymph nodes metastasis can rarely occur 9.
Which is the highest risk site for oral squamous cell carcinoma? ›The tongue is the anatomical site more frequently affected and it is usually associated with alcohol and tobacco use (2,3).
What is the 5 year survival for oral cavity squamous cell carcinoma? ›
If the cancer is diagnosed at an early stage, the 5-year relative survival rate for all people is 86%. About 28% of oral and oropharyngeal cancers are diagnosed at this stage. If the cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year relative survival rate is 69%.
What are the chances of dying from squamous cell carcinoma? ›Basal cell and squamous cell survival rates
Both types of cancer have a very high cure rate. According to the Canadian Cancer Society, the five-year survival rate for basal cell carcinoma is 100 percent. The five-year survival rate for squamous cell carcinoma is 95 percent.
Treatment should happen as soon as possible after diagnosis, since more advanced SCCs of the skin are more difficult to treat and can become dangerous, spreading to local lymph nodes, distant tissues and organs.
When is squamous cell carcinoma fatal? ›Untreated squamous cell carcinoma of the skin can destroy nearby healthy tissue, spread to the lymph nodes or other organs, and may be fatal, although this is uncommon.
What is the end stage of squamous cell carcinoma? ›Stage 4 squamous cell carcinoma
In stage 4, the cancer can be any size and has spread (metastasized) to one or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.
Recurrence of cSCC indicates an aggressive tumor, and metastatic rates for these tumors are 25–30%.
How do you treat oral squamous cell carcinoma? ›Treatment with surgery alone or in combination with adjuvant radiotherapy for more advanced lesions is the standard of care. Major advances have been made in surgical approaches,reconstructive options, and the rehabilitation of patients who have oral cavity SCC.
How bad is stage 2 squamous cell carcinoma? ›Stage 2 – Cancer has grown deep into the skin and displays one or more high-risk features (such as metastasis to nerves or lower skin layers), but has not spread to nearby lymph nodes or healthy tissues. Stage 3 – Cancer has grown into lymph nodes, but has not spread to any organs other than the skin.
Is oral squamous cell carcinoma aggressive? ›Tongue squamous cell carcinoma is one of the most aggressive tumours in behaviour. Even at early stages may the patient need to be submitted to a treatment plan consisting of radio/chemotherapy besides surgical removal of the tumour (31).
What is the best treatment for squamous cell carcinoma stage 2? ›In general, stage 2 cancers tend to be treated locally with surgery and/or radiation therapy. Chemotherapy or other drugs may be used during stage 2 cancer treatment in some cases.
What is the most important prognostic factor? ›
The most important prognostic factor in all human cancers is the stage at presentation, which is the anatomic extent of the disease.
What are poor prognostic indicators? ›Factors that predict a better outcome are called 'good' or 'favorable' prognostic factors. Those that predict for worse outcomes are called 'poor' prognostic factors.
What is prognostic test in assessment? ›Prognostic tests act as a means of estimation and prediction of the future career. The prognostic test combines basic aspects taken from an assessment of learning processes and an assessment of learning achievements and tries to formulate a diagnosis for the student's future.
What is the difference between predictive marker and prognostic marker? ›Prognostic biomarkers are often identified from observational data and are regularly used to identify patients more likely to have a particular outcome. To identify a predictive biomarker, there generally should be a comparison of a treatment to a control in patients with and without the biomarker.
What is prognostic and predictive markers? ›A prognostic biomarker provides information about the patients overall cancer outcome, regardless of therapy, whilst a predictive biomarker gives information about the effect of a therapeutic intervention. A predictive biomarker can be a target for therapy.
What are diagnostic vs prognostic biomarkers? ›Discussion. Biomarkers can be diagnostic (determine the presence and type of cancer), prognostic (give information on the patient's overall cancer outcome with or without standard treatment), or predictive (help to identify which treatment the patient is most likely to respond to or benefit from).
What is the formula for prognostic score? ›Calculation. The index is calculated using the formula: NPI = [0.2 x S] + N + G.
How precise are the prognostic estimates? ›How precise are the prognostic estimates? To determine the precision of the estimates we need to look at the 95% confidence intervals (CI) around the estimate. The narrower the CI, the more useful the estimate. The precision of the estimates depends on the number of observations on which the estimate is based.
What is the difference between a prediction and a prognosis? ›A physician can guess (predict) how long a patient will live. Experienced physicians know better than to offer a prediction with any degree of certainty. An accurate assessment of prognosis differs from a prediction in that it requires stating a range of survival based upon relevant data.
What is the most important risk factor for squamous cell carcinoma? ›Most squamous cell carcinomas of the skin result from prolonged exposure to ultraviolet (UV) radiation, either from sunlight or from tanning beds or lamps. Avoiding UV light helps reduce your risk of squamous cell carcinoma of the skin and other forms of skin cancer.
What features are important in the prognosis of carcinoma? ›
Some of the factors that affect prognosis include: The type of cancer and where it is in your body. The stage of the cancer, which refers to the size of the cancer and if it has spread to other parts of your body. The cancer's grade, which refers to how abnormal the cancer cells look under a microscope.
What is the most important prognostic factor all? ›The major prognostic factors for survival in adult ALL are age, cytogenetic abnormalities, immunologic subtype, white blood cell (WBC) count, and time to achieve complete remission (CR).
Which are some common risk factors for oral squamous cell cancers? ›- Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others.
- Heavy alcohol use.
- Excessive sun exposure to your lips.
- A sexually transmitted virus called human papillomavirus (HPV)
- A weakened immune system.
- Prolonged sun exposure. High exposure to the sun, without sun protection measures, is linked with cancer in the lip area.
- Human papillomavirus (HPV). ...
- Gender. ...
- Fair skin. ...
- Age. ...
- Poor oral hygiene. ...
- Poor diet/nutrition. ...
- Weakened immune system.
Recurrence of cSCC indicates an aggressive tumor, and metastatic rates for these tumors are 25–30%.
What are the three most important prognostic factors in determining long term survival? ›What are the three most important prognostic factors in determining long-term survival for children with acute leukemia? A. Histologic type of disease, initial platelet count, and type of treatment.
What are prognostic indicators examples? ›Prognostic or predictive factors may include patient characteristics such as age, ethnicity, sex, or smoking status, disease characteristics such as disease stage or nodal status, and molecular markers such as HER2 amplification and K ras mutation.
What features are suggestive of metastatic squamous cell carcinoma? ›Metastatic squamous neck cancer with occult primary is a disease in which squamous cell cancer spreads to lymph nodes in the neck and it is not known where the cancer first formed in the body. Signs and symptoms of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat.
Which cancers have the best prognosis? ›Thyroid cancer: At stage 1 and 2, the five-year survival is 98–100%. Melanoma: At stage 1, the five-year survival is about 99%. Cervical cancer: The five-year relative survival rate for all localized stages is 92%. Hodgkin lymphoma: The five-year relative survival rate of about 92-95 % for stage 1 and 2.
What is a bad prognostic factor? ›Factors that predict a better outcome are called 'good' or 'favorable' prognostic factors. Those that predict for worse outcomes are called 'poor' prognostic factors.
What are poor prognostic factors? ›
High disease activity, the early presence of erosions, and autoantibody positivity are the most frequently used poor prognostic factors but other features, such as functional disability, extraarticular disease, or multibiomarkers, are also assessed.