Objectives: There is limited knowledge regarding the impact of lifestyle changes on cardiovascular events and mortality among individuals with prehypertension or prediabetes.

Methods: This was a serial retrospective cohort study utilizing data from the Korean National Health Insurance Service Health Screening Cohort. The primary outcome considered in the study was major adverse cardiovascular events (MACE).

Results: A higher risk of MACE was found in men with prehypertension whose unhealthy lifestyle deteriorated (hazard ratio [HR], 1.13; 95% CI, 1.04–1.23; P=0.004), those who gained weight (HR, 1.15; 95% CI, 1.03–1.28; P=0.010), and those who began smoking (HR, 1.34; 95% CI, 1.17–1.55; P<0.001). Conversely, a reduced risk of MACE was observed in men with prehypertension who improved their unhealthy lifestyle, quit smoking, reduced alcohol consumption, or increased the frequency of physical activity. In men with prediabetes, the risk of MACE was higher in those whose unhealthy lifestyle worsened (HR, 1.23; 95% CI, 1.12–1.35; P<0.001), those who gained weight (HR, 1.19; 95% CI, 1.06–1.33; P=0.003), those who started smoking (HR, 1.41; 95% CI, 1.22–1.64; P<0.001), and those who decreased their physical activity frequency (HR, 1.21; 95% CI, 1.09–1.35; P<0.001).

Conclusion: Preventive lifestyle changes reduce cardiovascular events and mortality, particularly in men at risk of developing hypertension or type 2 diabetes.

Objectives

Cancer stem cells are defined as focal cluster of cells within a tumor that possess the capacity for self-renewal and differentiation into phenotypically heterogeneous cells. Cluster of differentiation 44 (CD44) is considered one of the gastric cancer stem cell markers. We aimed to investigate how the expression of CD44 varies according to the clinicopathologic characteristics in gastric cancer.

Methods

For this study, 157 patients who received an operation due to gastric cancer between May 1998 and December 2009 were selected. CD44 immunohistochemistry was reviewed using the semi-quantitative scoring of intensity and proportion. The sum of the intensity and proportion scores was calculated, and a score of 2 or less was deemed ‘CD44-negative’ and 3 or more as ‘CD44-positive.’

Results

Among the final 143 subjects, 69 (48.3%) were CD44 positive. Older age, intestinal type gastric cancer, lymphatic invasion, and lymph node metastasis were significantly correlated with expression of CD44. In the multivariate analysis, older age was the only independent factor associated with CD44 expression (P=0.028). CD44 expression was correlated with overall survival, 5-year survival, and disease-free survival. In the multivariate analysis, older age, male gender, and lymphatic invasion were independent predictors of poor overall survival. Also, older age and lymphatic invasion were significant factors in 5-year survival, and lymphatic invasion was an independent factor of poor disease-free survival.

Conclusion

Older age (≥60 years) was independently associated with CD44 expression in gastric cancer patients. Also, CD44 expression was correlated with poor prognosis in gastric cancer patients.

Citations

• Comparison of human epidermal growth factor receptor 2 and cancer stem cell markers like CD44 and CD133 expressions with clinicopathological parameters in gastric cancer
  Melin GECER, Nur BÜYÜKPINARBAŞILI, Seval TURNA, Mehmet BEŞİROĞLU, Zuhal GUCIN
  The European Research Journal.2023; 9(5): 1015.     CrossRef
• Clinical and prognostic significances of cancer stem cell markers in gastric cancer patients: a systematic review and meta-analysis
  Mahdieh Razmi, Roya Ghods, Somayeh Vafaei, Maryam Sahlolbei, Leili Saeednejad Zanjani, Zahra Madjd
  Cancer Cell International.2021;[Epub]     CrossRef