BACKGROUND & AIMS: The relationship between preferred objects associated with stereotypy, stereotypic behavior, and accuracy of responding during a counting task by a child with autism was analyzed. Object preference was determined by presenting the child with different sets of objects and asking him to choose one. His choices were then rank ordered into three groupslow, medium, and high preference objects. Counting performance within each of the three object groups was then analyzed in a multi-element design, alternating preference groups. Teaching with high-preference objects occasioned more stereotypic behavior and less accurate counting than teaching with medium- and low-preference objects. Thus, there exists the possibility that teaching may be less successful with certain teaching materials, especially if those materials evoke high rates of incompatible behaviors.

背景与目标： 分析了与自闭症儿童在计数任务中与刻板印象相关的首选对象，刻板行为和响应准确性之间的关系。对象偏好是通过向孩子展示不同的对象集并要求他选择一个来确定的。然后将他的选择排序为三个慢，中和高偏好对象。然后，在多元素设计 (交替的偏好组) 中分析了三个对象组中每个对象组的计数性能。与中低偏好对象的教学相比，高偏好对象的教学产生了更多的刻板行为和更不准确的计数。因此，存在使用某些教材进行教学可能不太成功的可能性，尤其是如果这些教材引起高度的不相容行为。

BACKGROUND & AIMS: BACKGROUND:This study aimed at analyzing different treatments of breast cancer (BC) prevalent in the region, their effect on patients' survival, and discusses the most suitable method within available resources. METHODS:The study was set up at a tertiary care hospital in north India. We retrospectively reviewed data of 473 female BC patients who attended the departments of Surgical Oncology and Radiotherapy from January 1997 to December 1999. Patients with cTNM stage IV and inoperable stage III were included; those who defaulted or were lost to follow-up were excluded. Out of 473 patients, 372 were selected. The selected patients were divided into groups on the basis of place and type of local treatment they received: (1) local excision only, (2) standard breast conservation therapy (BCT), (3) total mastectomy (TM) + axillary lymph node dissection + radiotherapy (RT), and (4) modified radical mastectomy (MRM) + RT. Data regarding recurrence and survival were analyzed in December 2005. Minimum follow-up was 6 years. RESULTS:Overall recurrence rates were significantly higher in patients operated elsewhere (P <0.0001). Of 194 operated at our Breast Unit, 25 (14.6%) of 171 MRM patients and none of 23 BCT had recurrence. Of 178 patients operated elsewhere, 44 (100%), 6 (42.9%), 41 (41%), and 8 (40%) developed recurrence in groups 1, 2, 3, and 4 respectively. Overall survival was significantly better in patients with MRM at our unit versus TM outside (93.6% vs. 80%). CONCLUSIONS:Several types of treatment from improper local excision alone, BCT, TM, to a carefully done MRM are prevalent here. Properly done, MRM yields significant local control with survival benefit and appears to remain the gold standard in management of our BC patients.

背景与目标：

BACKGROUND & AIMS: :Immediate placement refers to the placement of an implant into a tooth socket at the time of extraction; early placement refers to the placement of an implant after substantial gingival healing, but before any clinically significant bone fill occurs within the socket. This study evaluated the success and survival rates of implants following immediate and early placement. 50 implants were placed in 36 patients. 26 immediate (group I) and 24 early placements (group II) were performed. Pain or tenderness with function, mobility, radiographic bone loss from initial surgery and exudate history were evaluated. Mean vertical bone loss in the immediate placement group was 0.55 mm and 0.80 mm in the early placement group. The survival rate for the immediate placement group was 96.16% with 51.6 months follow-up and in the early placement group was 100% with 61.9 months follow-up. The results of this study suggest that although the success and survival rates of early placed implants were a little higher and the follow up period was longer than immediately placed implants, the difference was not remarkable. In conclusion, both implant insertion techniques are safe and reliable procedures with considerably high survival rates.

背景与目标： : 立即放置是指在拔牙时将植入物放置在牙槽中; 早期放置是指在牙龈实质性愈合后但在牙槽内发生任何临床上重要的骨填充之前放置植入物。这项研究评估了立即和早期放置后植入物的成功率和存活率。在36例患者中放置了50个植入物。进行了26次即时放置 (I组) 和24次早期放置 (II组)。评估了疼痛或压痛的功能，活动度，初始手术引起的影像学骨丢失和渗出史。立即放置组的平均垂直骨丢失是0.55毫米的，而早期放置组的平均垂直骨丢失是0.80毫米的。立即放置组的生存率96.16% 为51.6个月的随访，而早期放置组的生存率100% 为61.9个月的随访。这项研究的结果表明，尽管早期放置的植入物的成功率和存活率比立即放置的植入物高一些，并且随访时间更长，但差异并不显着。总之，两种植入物插入技术都是安全可靠的程序，存活率很高。

BACKGROUND & AIMS: BACKGROUND:The Nutrition Embedded Evaluation Programme Impact Evaluation (NEEP-IE) study is a cluster randomised controlled trial designed to evaluate the impact of a childcare centre-based integrated nutritional and agricultural intervention on the diets, nutrition and development of young children in Malawi. The intervention includes activities to improve nutritious food production and training/behaviour-change communication to improve food intake, care and hygiene practices. This paper presents the rationale and study design for this randomised control trial. METHODS:Sixty community-based childcare centres (CBCCs) in rural communities around Zomba district, Malawi, were randomised to either (1) a control group where children were attending CBCCs supported by Save the Children's Early Childhood Health and Development (ECD) programme, or (2) an intervention group where nutritional and agricultural support activities were provided alongside the routine provision of the Save the Children's ECD programme. Primary outcomes at child level include dietary intake (measured through 24-h recall), whilst secondary outcomes include child development (Malawi Development Assessment Tool (MDAT)) and nutritional status (anthropometric measurements). At household level, primary outcomes include smallholder farmer production output and crop-mix (recall of last production season). Intermediate outcomes along theorised agricultural and nutritional pathways were measured. During this trial, we will follow a mixed-methods approach and undertake child-, household-, CBCC- and market-level surveys and assessments as well as in-depth interviews and focus group discussions with project stakeholders. DISCUSSION:Assessing the simultaneous impact of preschool meals on diets, nutrition, child development and agriculture is a complex undertaking. This study is the first to explicitly examine, from a food systems perspective, the impact of a preschool meals programme on dietary choices, alongside outcomes in the nutritional, child development and agricultural domains. The findings of this evaluation will provide evidence to support policymakers in the scale-up of national programmes. TRIAL REGISTRATION:ISRCTN registry, ID: ISRCTN96497560 . Registered on 21 September 2016.

背景与目标：

BACKGROUND & AIMS: :Leiomyosarcoma of the innominate vein is a rare but usually lethal disease. We report the case of a 50-year-old woman, undergoing a curative resection of the tumor. She is alive and free of disease at 88-month follow-up. Surgical excision remains the current optimal treatment able to provide a chance of cure. KEY WORDS: Late survival, Venous leiomyosarcoma.

背景与目标： : 无名静脉平滑肌肉瘤是一种罕见但通常致命的疾病。我们报告了一名50岁的女性，正在接受肿瘤的根治性切除。在88个月的随访中，她还活着并且没有疾病。手术切除仍然是目前能够提供治愈机会的最佳治疗方法。关键词: 晚期生存，静脉平滑肌肉瘤。

BACKGROUND & AIMS: BACKGROUND:This retrospective study investigated overall survival (OS) and factors influencing OS in Swedish patients with metastatic renal cell carcinoma (mRCC) during the pre- (2002-2005), early (2006-2008), and late (2009-2012) targeted therapy (TT) era. METHODS:Three national Swedish registries identified patients with mRCC. Median OS was estimated using the Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards regression. Subgroup analysis was conducted for patients with synchronous metastases (M1) and the elderly (aged≥75y). RESULTS:A total of 4,217 patients with mRCC were identified, including 1,533 patients with M1 and 1,275 elderly patients. For patients with mRCC diagnosed in 2002 to 2005, 2006 to 2008, and 2009 to 2012, median OS was 10.0, 13.0, and 18.0 months. Similarly, median OS improved in the M1 and elderly populations. Elderly patients were less likely to be prescribed TT (≥75 vs.<75y): 18.3 vs. 63.5% (in 2006-2008) and 28.6% vs. 55.9% (in 2009-2012). Diagnosis of mRCC in 2009 to 2012, nephrectomy and TT prescription were associated with improved OS in the total mRCC, M1, and elderly populations. CONCLUSION:This real-world study showed continued significant improvement in mRCC OS during the late TT era, including in M1 and elderly populations. TT should be considered for all patients with mRCC based on tolerability, regardless of age.

背景与目标：

BACKGROUND & AIMS: :Upregulation of lipogenesis is a hallmark of cancer and blocking the lipogenic pathway is known to cause tumor cell death by apoptosis. However, the exact role of lipogenesis in tumor initiation is as yet poorly understood. We examined the expression profile of key lipogenic genes in clinical samples of ductal carcinoma in situ (DCIS) of breast cancer and found that these genes were significantly upregulated in DCIS. We also isolated cancer stem-like cells (CSCs) from DCIS.com cell line using cell surface markers (CS24(-)CD44(+)ESA(+)) and found that this cell population has significantly higher tumor-initiating ability to generate DCIS compared with the non-stem-like population. Furthermore, the CSCs showed significantly higher level of expression of all lipogenic genes than the counterpart population from non-tumorigenic breast cancer cell line, MCF10A. Importantly, ectopic expression of SREBP1, the master regulator of lipogenic genes, in MCF10A significantly enhanced lipogenesis in stem-like cells and promoted cell growth as well as mammosphere formation. Moreover, SREBP1 expression significantly increased the ability of cell survival of CSCs from MCF10AT, another cell line that is capable of generating DCIS, in mouse and in cell culture. These results indicate that upregulation of lipogenesis is a pre-requisite for DCIS formation by endowing the ability of cell survival. We have also shown that resveratrol was capable of blocking the lipogenic gene expression in CSCs and significantly suppressed their ability to generate DCIS in animals, which provides us with a strong rationale to use this agent for chemoprevention against DCIS.

背景与目标： : 脂肪生成的上调是癌症的标志，已知阻断脂肪生成途径会通过凋亡导致肿瘤细胞死亡。然而，脂肪生成在肿瘤起始中的确切作用尚不清楚。我们检查了乳腺癌导管原位癌 (DCIS) 临床样本中关键脂原基因的表达谱，发现这些基因在DCIS中显着上调。我们还使用细胞表面标记 (CS24(-)CD44(+)ESA(+)) 从DCIS.com细胞系中分离出癌症干细胞样细胞 (CSCs)，发现该细胞群与非干细胞样群体相比，产生DCIS的肿瘤起始能力明显更高。此外，与来自非致瘤性乳腺癌细胞系MCF10A的对应群体相比，CSCs显示出所有脂质基因的表达水平显着更高。重要的是，MCF10A中脂肪生成基因的主要调节剂SREBP1的异位表达显着增强了干细胞样细胞的脂肪生成，并促进了细胞生长和mammohere形成。此外，SREBP1的表达显着提高了MCF10AT (另一种能够产生DCIS的细胞系) 在小鼠和细胞培养中的CSCs的细胞存活能力。这些结果表明，通过赋予细胞存活能力，脂肪生成的上调是DCIS形成的先决条件。我们还表明，白藜芦醇能够阻断CSCs中的脂肪基因表达，并显着抑制其在动物中产生DCIS的能力，这为我们提供了使用该药物对DCIS进行化学预防的有力依据。

BACKGROUND & AIMS: BACKGROUND:Most studies investigate the association between the baseline Romano-Charlson comorbidity index (CCI) and survival on hemodialysis (HD). Few consider the effect of progression in the CCI score (CCIp) on patient survival before HD initiation. That is CCIp = CCI-1 - CCI-3, where CCI(-1) is the CCI score in the first year before HD initiation, and CCI-3 is the CCI score in the third year before HD initiation. The present study investigated whether CCIp affects the survival of incident HD patients. METHODS:Using the National Health Insurance (NHI) Research Database of Taiwan, we recruited 7391 adult incident HD patients in the year 2006 for this historical cohort study. We followed the cohort until the end of 2007. Using the Romano-Charlson method, each comorbidity was assigned a score of 1, 2, 3 or 6. The scores were then summed to produce a total score (CCI), which predicts mortality. The log-rank test and a Cox regression model were used to analyze the association between CCIp and survival, and the risk markers of survival. RESULTS:Diabetes, ulcers, congestive heart failure, chronic pulmonary disease and cerebrovascular disease were the most common comorbid conditions. The median CCI-3 was 2 (interquartile range 0-3). The overall survival rate in 1 year was 82.8%. In incident patients with a CCI-3 score of <3, the rate was 85.1%, and in patients with a CCI-3 score of ≥ 3, the rate was 76.8%. Each increase of one point in the CCI-3 score (HR = 1.69, 95% CI 1.42-2.01) and the CCIp (HR = 1.22, 95% CI 1.17-1.27) affected survival in HD patients. CONCLUSIONS:The CCI-3 and CCIp before HD initiation are valuable predictors of survival in incident patients.

背景与目标：

BACKGROUND & AIMS: :Pulmonary artery sling is an incomplete vascular ring, the result of the left pulmonary artery arising from the right pulmonary artery and effectively constricting the airway, and it usually presents within the first weeks to months of life. We report a surgical correction of tracheal stenosis for a two-year-old patient associated with pulmonary artery sling and tracheal broncus.

背景与目标： 肺动脉吊带是一种不完整的血管环，是左肺动脉从右肺动脉产生并有效收缩气道的结果，通常在生命的最初几周到几个月内出现。我们报告了一名两岁的肺动脉吊带和气管支气管相关患者的气管狭窄手术矫正。

BACKGROUND & AIMS: :Recent evidence suggests that between-individual variation in posture and posture transitions may have important health consequences in adults. The early life development of between-individual variation in posture and posture transitions has not been studied, and the physiological consequences of such variations in childhood are unknown, largely because of the absence of objective methods for measuring posture and posture transitions in young children. This study aimed to examine the objective measurement of posture transitions in pre-school children with the activPAL™ monitor (PAL Technologies, Glasgow). Single-unit activity monitors such as the activPAL™ have a limited output, with data categorized as 'sit/lie', 'stand' or 'walk' and the consequences of this for measurement of posture transitions in young children are unknown. Thirty children (mean age 4.1 years) were videoed for 1 h in nursery while wearing an activPAL™. Video was analysed on a second-by-second basis, with all postures categorized. From direct observation, time spent was sit/lie 46%; stand 35%; walk/run 16%; 3% was spent in heterogeneous non-sit/lie/upright postures (crawl, crouch, and kneel up). Despite these 'non-standard' postures being responsible for a low proportion of time, posture transitions involving them contributed to 34% of total transitions. There was a significant rank-order correlation (r = 0.79, p < 0.0001) between the number of posture transitions measured by activPAL™ and by direct observation. 'Non-standard' postures in young children are probably not a problem if the aim is to measure total time sedentary or active, and the activPAL™ may measure between-individual variation in transitions adequately in young children. However, non-standard postures may present problems for the detailed characterization of posture transitions in early childhood.

背景与目标： : 最近的证据表明，姿势和姿势转换的个体间差异可能对成年人的健康产生重要影响。尚未研究姿势和姿势转换的个体间变化的早期生活发展，并且这种变化在儿童时期的生理后果尚不清楚，这主要是因为缺乏客观的方法来测量幼儿的姿势和姿势转换。这项研究旨在检查activPAL学龄前儿童姿势转变的客观测量™监视器 (格拉斯哥PAL Technologies)。单单元活动监视器，如activPAL™输出有限，数据分类为 “坐/坐”，“站立” 或 “步行”，其对测量幼儿姿势转变的后果尚不清楚。30名儿童 (平均年龄4.1岁) 在托儿所观看了1小时的视频，同时穿着activPAL™。对视频进行了逐秒分析，并对所有姿势进行了分类。从直接观察来看，花费的时间是坐/躺46%; 站立35%; 步行/跑步16%; 3% 是在异质的非坐/躺/直立姿势 (爬行，蹲下和跪下) 中度过的。尽管这些 “非标准” 姿势负责低比例的时间，但涉及它们的姿势转变有助于34% 总转变。activPAL测量的姿势转换次数之间存在显着的顺序相关性 (r = 0.79，p <0.0001)™通过直接观察。如果目的是测量久坐或活动的总时间，那么幼儿的 “非标准” 姿势可能不是问题，而activPAL™可以充分衡量幼儿过渡中的个体间差异。但是，非标准姿势可能会为儿童早期姿势转变的详细表征带来问题。

BACKGROUND & AIMS: OBJECTIVE:To explore the prognostic value of the postsurgical half-life (HL) of serum alpha-fetoprotein (AFP). BACKGROUND:There is still a paucity of early surrogate indicators of clinical endpoints after liver resection of hepatocellular carcinoma (HCC). METHODS:The analysis was based on cohorts of 225 (exploration set) and 117 (validation set) treatment-naïve HCC patients undergoing curative liver resection. We defined 3 categories of AFP HL: early complete resolution of AFP, normal HL, and prolonged HL if the HL exceeded 7 days. Overall, probabilities of recurrence and survival were estimated and compared across the AFP HL categories. RESULTS:In the exploration cohort, 48 patients (21.3%) achieved early AFP complete resolution, 116 (51.6%) had normal HL, and 61 (27.1%) had prolonged HL. Long AFP HL was significantly associated with early postoperative recurrence (P < 0.001), as was microvascular invasion. Early recurrence within 2 years of resection was observed in 59% of the patients with prolonged AFP HL compared with only 29.3% of those with normal AFP HL (P < 0.001). A log-rank test followed by multivariate Cox analysis identified an independent function of prolonged AFP HL in predicting shorter recurrence-free survival and overall survival time after HCC resection (hazard ratios, 2.81 and 3.58; P < 0.001). When AFP HL analysis was applied to the validation cohort, the association between prolonged AFP HL and survival endpoints (hazard ratio, 11.63 and 16.39; P < 0.001) was confirmed.

背景与目标：

BACKGROUND & AIMS: :Chondrolipoma is an extremely rare variant of lipoma with cartilaginous metaplasia. The presence of nonlipomatous components can lead to a variety of entities in the differential diagnosis from the radiologic findings. We describe an unusual case of a chondrolipoma occurring in the right ankle of a 9-year-old female. Physical examination showed a 3.5-cm, elastic-hard, poorly mobile, nontender mass adherent to the Achilles tendon. Plain radiographs revealed a faintly calcified soft tissue mass without bone involvement. Magnetic resonance imaging showed a well-defined mass with 2 components with heterogeneous signal intensity, suggesting the coexistence of a fatty area and another nonlipomatous component. Marginal excision of the tumor was performed. Histologically, the tumor was composed of mature adipose tissue studded with islands of mature hyaline cartilage. Based on these findings, the tumor was diagnosed as a chondrolipoma. The patient had no evidence of local recurrence within 9 months of follow-up. To the best of our knowledge, this is the first case of chondrolipoma originating from the ankle in a child.

背景与目标： : 软骨脂肪瘤是脂肪瘤的一种极其罕见的变异型软骨化生。非脂肪瘤性成分的存在可导致放射学发现的鉴别诊断疾病中的各种实体。我们描述了一个9岁女性右脚踝发生软骨脂肪瘤的不寻常病例。体格检查显示跟腱附着有3.5厘米，弹性坚硬，移动不良，不柔软的肿块。X线平片显示微弱的钙化软组织肿块，没有骨受累。磁共振成像显示出一个明确的质量，其中有2个成分，信号强度不均匀，表明脂肪区域和另一种非脂肪瘤成分并存。进行了肿瘤的边缘切除术。从组织学上讲，肿瘤由成熟的脂肪组织组成，这些脂肪组织散布着成熟的透明软骨岛。根据这些发现，该肿瘤被诊断为软骨脂肪瘤。在随访的9个月内，患者没有局部复发的证据。据我们所知，这是第一例起源于儿童脚踝的软骨脂肪瘤。

BACKGROUND & AIMS: :In 2015, there will be an estimated 11.3 million cancer survivors. With an increasing population of cancer survivors, it is imperative to understand the treatment options available and outcomes for chemotherapy-related cardiomyopathy. Anthracycline-based chemotherapy causes heart failure in approximately 5% of patients. Orthotopic heart transplantation (OHT) is an option for cancer survivors in complete remission who develop end-stage heart failure. We examined retrospective OHT data collected from the United Network of Organ Sharing from 1987 to 2011. The primary aim was to characterize the survival in patients with either the primary diagnosis of "dilated cardiomyopathy: Adriamycin" (DCA) versus "all other" causes of cardiomyopathy. The secondary aim was to define the differences in the primary cause of death and to describe the temporal relationship of DCA OHT. The United Network of Organ Sharing database identified 453 OHTs for the diagnosis of DCA and 51,312 OHTs for all other causes of cardiomyopathy. The DCA group was significantly younger with a greater percentage of women. After adjusting for age, gender, and history of malignancy, the 10-year survival curves showed that patients with DCA have an improved survival compared to those with all other causes of cardiomyopathy (hazard ratio 1.28, p = 0.026). No difference was found in the primary cause of death between the 2 groups. A statistically significant increasing temporal trend was seen in the number of OHTs for the diagnosis DCA. In conclusion, patients who undergo OHT for DCA have favorable 10-year survival, making OHT a good therapeutic option for end-stage heart failure due to anthracyclines. Additionally, no increased risk of cancer-related deaths was found in the DCA group, demonstrating that recurrent malignancy does not affect long-term survival. The temporal trends demonstrated that DCA remains a significant problem for cancer survivors.

背景与目标： : 2015年，估计将有1130万名癌症幸存者。随着癌症幸存者人数的增加，必须了解与化疗相关的心肌病的可用治疗选择和结果。基于蒽环类药物的化疗在大约5% 的患者中引起心力衰竭。原位心脏移植 (OHT) 是完全缓解并发展为终末期心力衰竭的癌症幸存者的一种选择。我们检查了从器官共享1987年2011年联合网络收集的回顾性OHT数据。主要目的是表征主要诊断为 “扩张型心肌病: 阿霉素” (DCA) 与 “所有其他” 心肌病原因的患者的生存率。次要目的是定义主要死亡原因的差异并描述DCA OHT的时间关系。器官共享数据库联合网络确定了用于诊断DCA的453 oht和用于所有其他原因的心肌病的51,312 oht。DCA组明显年轻，女性比例更高。在调整了年龄，性别和恶性肿瘤病史后，10年生存曲线显示，DCA患者与所有其他原因的心肌病患者相比，生存率有所提高 (风险比1.28，p = 0.026)。两组之间的主要死亡原因没有发现差异。在诊断DCA的oht数量中，统计学上显着增加的时间趋势。总之，接受OHT治疗DCA的患者具有良好的10年生存率，这使OHT成为蒽环类药物导致的终末期心力衰竭的良好治疗选择。此外，在DCA组中没有发现癌症相关死亡的风险增加，这表明复发性恶性肿瘤不会影响长期生存。时间趋势表明，DCA仍然是癌症幸存者的重要问题。

BACKGROUND & AIMS: :This prospective study validates the finding from retrospective research that having an inpatient lay care-partner (CP) is associated with better survival following allogeneic BMT. Compared with patients without a CP (n=76), patients with a CP (n=88) have significantly better OS (P=0.017) and relapse-free survival (RFS) (P=0.020). Four-year and median survivals were 42% and 36 months among patients with CPs, compared with 26% and 10 months among those without CPs. Four-year survival and median RFS were 39% and 25 months among those with CPs, compared with 23% and 7 months among those without CPs. Further, better survival and RFS were associated with CP visit duration of >3 h per day (P=0.005 and P=0.007, respectively) and with CP frequency of visits >75% of inpatient days (P=0.004 and P=0.010, respectively). A CP support program should encourage not only presence of a CP but also duration and frequency of CP visits associated with better patient survival.

背景与目标： : 这项前瞻性研究证实了回顾性研究的发现，即拥有住院非专业护理伴侣 (CP) 与同种异体BMT后更好的生存率相关。与没有CP的患者 (n = 76) 相比，具有CP的患者 (n = 88) 具有明显更好的OS (P = 0.017) 和无复发生存率 (RFS) (P = 0.020)。CPs患者的4年和中位生存期分别为42% 和36个月，而无CPs的患者为26% 和10个月。患有CPs的患者的四年生存率和中位RFS分别为39% 和25个月，而没有CPs的患者为23% 和7个月。此外，更好的生存率和RFS与每天> 3 h的CP访视时间 (分别为P = 0.005和P = 0.007) 和CP访视频率> 住院天数的75% (分别为P = 0.004和P = 0.010) 相关。CP支持计划不仅应鼓励CP的存在，而且还应鼓励CP就诊的持续时间和频率与更好的患者生存率相关。

BACKGROUND & AIMS: INTRODUCTION:Chronic lymphocytic leukemia (CLL) is a disorder of mature but dysfunctional monoclonal B cells. Microenvironment, antigenic stimulation and genetical mutations are demonstrated in etiopathogenesis. We aimed to evaluate the expression of CD11c in patients with CLL and its possible clinical significance. METHODS:Data of 259 patients with CLL between 2010 and 2016 in Trakya University Faculty of Medicine, including age at diagnosis, sex, whole blood count, stage, percentage of CLL cells in bone marrow, line of treatments, development of Richter's transformation and secondary tumors, autoimmune complications, IgG level, prognostic cytogenetic analysis, and length of survival were recorded from files. RESULTS:151 patients were male (58.3%) and 108 were male (41.7%). Mean age was 70 (21-92) years. CD11c was observed to be positive (>%20) in 103 patients (39.8%). Development of Richter's transformation, secondary tumors and ITP was significantly frequent in patients with CD11c positivity (P values .000, .003, .000 respectively). Also, IgG levels were significantly lower in this group (P = .000). Hemoglobin level, RAI stage and bone marrow CLL infiltration percentage were statistically related with CD11c (P values .036, .037, .000 respectively). Finally, CD11c was statistically related (in positive group 70 months, negative group 79 months, P = .001). CONCLUSION:CD11c, expressed not only in Hairy cell leukemia but also in dendritic cells, macrophages and monocytes is a differentiation marker for inflammation. Prolonged inflammation in the microenvironment of CLL cells may cause a susceptibility to autoimmune disorders and secondary tumors in CLL, in this way, an increase in mortality.

背景与目标：