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Gokce SF, Bolayır A, Cigdem B, Yildiz B. The role of systemic ımmune ınflammatory ındex in showing active lesion ın patients with multiple sclerosis : SII and other inflamatuar biomarker in radiological active multiple sclerosis patients. BMC Neurol 2023; 23:64. [PMID: 36765289 PMCID: PMC9912215 DOI: 10.1186/s12883-023-03101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/31/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) has two pathophysiological processes, one inflammatory and the other degenerative. We investigated the relationship between active lesions on magnetic resonance imaging showing the inflammatory phase in MS patients and serum parameters that can be used as inflammatory biomarkers. Thus, we aim to detect the inflammatory period in clinical and radiological follow-up and to reveal the period in which disease-modifying treatments are effective with serum parameters. METHODS One hundred eighty-six MS patients presented to our hospital between January 2016 and November 2021 and 94 age- and sex-matched healthy volunteers were recruited for our study. While 99 patients had active lesions on magnetic resonance imaging, 87 patients did not have any active lesions. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) were determined. The SII (systemic immune inflammatory index) value was calculated according to the platelet X neutrophil/lymphocyte ratio formula. RESULTS NLR, MLR, PLR and SII values were found to be statistically significantly higher in MS patients than in the control group. The NLR, MLR, PLR and SII were higher in the active group with gadolonium than in the group without active lesions. In addition, the cutoff values that we can use to determine the presence of active lesions were 1.53, 0.18, 117.15, and 434.45 for NLR, MLR PLR and SII, respectively. CONCLUSIONS We found that all parameters correlated with radiological activity. In addition, we showed that we can detect the inflammatory period with high sensitivity and specificity with the cutoff value used for SII and PLR. Among these easily accessible and inexpensive evaluations, we concluded that SII, including the values in the PLR formula, can come to the fore.
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Affiliation(s)
- Seyda Figul Gokce
- School of Medicine, Neurology Department, Sivas Cumhuriyet University, Sivas, Turkey.
| | - Asli Bolayır
- grid.411689.30000 0001 2259 4311School of Medicine, Neurology Department, Sivas Cumhuriyet University, Sivas, Turkey
| | - Burhanettin Cigdem
- grid.411689.30000 0001 2259 4311School of Medicine, Neurology Department, Sivas Cumhuriyet University, Sivas, Turkey
| | - Bulent Yildiz
- grid.411689.30000 0001 2259 4311School of Medicine, Radiology Department, Sivas Cumhuriyet University, Sivas, Turkey
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Gu Y, Fu Y, Pan X, Zhou Y, Ji C, Zhao T, Miao H, Lv H, Da J, Ge J, Wang L, Qu L, Ge S, Guo H, Zhou W. Prognostic value of systemic immune-inflammation index in non-metastatic clear cell renal cell carcinoma with tumor thrombus. Front Oncol 2023; 13:1117595. [PMID: 36776325 PMCID: PMC9909392 DOI: 10.3389/fonc.2023.1117595] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
This study aims to determine the prognostic value of SII for non-metastatic clear cell renal cell carcinoma (ccRCC) patients with venous tumor thrombus (VTT). We retrospectively collected and analyzed 328 non-metastatic ccRCC patients with VTT who underwent radical nephrectomy and thrombectomy from 3 tertiary centers in China between 2011 to 2021. Kaplan-Meier analyses and Cox proportional hazard analyses were used to determine its prognostic value for overall survival (OS) and disease free survival (DFS). The Harrell concordance index (C-index), receiver operating characteristic curve (ROC) analysis, and decision curve analysis (DCA) were used to evaluate its role in the improvement of prognostic accuracy of the existing models. Nomogram models containing the SII were then developed and evaluated by R. Patients were divided into low-SII and high-SII groups based on the SII optimal cut-off value 912 calculated by the Youden index in all patients. Higher SII was correlated with more symptoms, longer surgical time, higher WHO/ISUP grade, and longer tumor diameter. Kaplan-Meier analyses revealed significant differences in OS and DFS between two groups. Multivariate analyses revealed that SII was an independent prognostic factor for OS (HR:2.220, p=0.002) and DFS (HR:1.846, p=0.002). Compared with other indicators, SII had a superior accuracy (c-index=0.630 for OS and 0.595 for DFS). It also improved the performance of models for predicting OS and DFS (all p <0.01). Based on the results of LASSO Cox regression analysis, we constructed a nomogram to predict OS and it performed well on both the training cohort (AUC=0.805) and the validation cohort (AUC=0.795). Risk stratification based on nomogram can distinguish patients with different risks (all p <0.001). Preoperative SII is an independent predictive factor for OS and DFS of non-metastatic ccRCC patients with VTT. It can be used to improve the performance of current risk models.
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Affiliation(s)
- Yufeng Gu
- Department of Urology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Yao Fu
- Department of Pathology, Drum Tower Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Xin Pan
- Department of Urology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Yulin Zhou
- Department of Urology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Changwei Ji
- Department of Urology, Drum Tower Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Tangliang Zhao
- Department of Urology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - He Miao
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Huichen Lv
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jianping Da
- Department of Urology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Jingping Ge
- Department of Urology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Linhui Wang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Le Qu
- Department of Urology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Silun Ge
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, China,*Correspondence: Wenquan Zhou, ; Hongqian Guo, ; Silun Ge,
| | - Hongqian Guo
- Department of Urology, Drum Tower Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China,*Correspondence: Wenquan Zhou, ; Hongqian Guo, ; Silun Ge,
| | - Wenquan Zhou
- Department of Urology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China,*Correspondence: Wenquan Zhou, ; Hongqian Guo, ; Silun Ge,
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Kulacaoglu F, Yıldırım YE, Aslan M, İzci F. Neutrophil to lymphocyte and monocyte to high-density lipoprotein ratios are promising inflammatory indicators of bipolar disorder. Nord J Psychiatry 2023; 77:77-82. [PMID: 36074909 DOI: 10.1080/08039488.2022.2116106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIMS The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), and monocyte to high-density lipoprotein (MHR) are indicators of inflammation. In this study, we aimed to examine the possible association between NLR, PLR, MLR, and MHR in the same patients with bipolar disorder (BD) during their manic, depressive, and euthymic episodes. METHODS The participants of this study consisted of 61 patients with BD, aged between 18 and 65, who were hospitalized with a diagnosis of BD. Patients who were hospitalized during their manic and depressive episodes and medication free for at least 1 month before hospitalization were included. White blood cell, neutrophil, lymphocyte, platelet, and monocyte counts, high-density lipoprotein (HDL) cholesterol, and C reactive protein (CRP) levels were recorded. RESULTS Leukocytes (p = 0.000), neutrophil (p = 0.009), monocyte counts (p = 0.012), CRP levels (p = 0.026), NLR (p = 0.025), and MHR (p = 0.011) values were significantly higher in their manic episode and depressive episode compared with the values in their remission period. There was no significant difference between manic and depressive episodes in terms of inflammation parameters. Significant positive correlations were found between the number of depressive episodes and patients' CRP levels (p = 0.031). CONCLUSIONS This study was the first study to examine the inflammatory markers such as NLR, MLR, PLR, and MHR levels in same patients with BD during their three episodes of disorder. Both NLR and MHR values in manic and depressive episodes were higher than euthymic episodes. NLR and MHR were useful inflammatory markers to evaluate inflammation in bipolar patients.
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Affiliation(s)
- Filiz Kulacaoglu
- Department of Psychiatry, Health Sciences University Prof. Dr. Mazhar Osman Bakirkoy Research and Training Hospital for Psychiatry and Neurological Diseases, Istanbul, Turkey
| | | | - Metin Aslan
- Department of Psychiatry, Health Sciences University Erenkoy Research and Training Hospital for Psychiatry and Neurological Diseases, Istanbul, Turkey
| | - Filiz İzci
- Department of Psychiatry, Health Sciences University Erenkoy Research and Training Hospital for Psychiatry and Neurological Diseases, Istanbul, Turkey
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Xing N, Wang H, Huang Y, Peng J. Enhanced recovery after surgery program alleviates neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients undergoing gynecological surgery. Front Med (Lausanne) 2023; 10:1057923. [PMID: 37138751 PMCID: PMC10150635 DOI: 10.3389/fmed.2023.1057923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/15/2023] [Indexed: 05/05/2023] Open
Abstract
Background To evaluate the efficacy of the enhanced recovery after surgery (ERAS) programs on the systemic inflammatory response (SIR) of patients following gynecological surgery, a randomized controlled trial was performed to compare the ERAS programs with the conventional perioperative care programs. Furthermore, novel SIR markers could be identified to evaluate the ERAS programs of gynecological surgery. Methods Patients undergoing gynecological surgery were randomly allocated to either the ERAS group or the conventional group. The correlations between the elements of ERAS protocols and SIR markers following gynecological surgery were evaluated. Results A total of 340 patients who underwent gynecological surgery were enrolled (ERAS = 170; conventional = 170). First, we identified whether the ERAS programs after gynecological surgery reduced the perioperative difference between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Interestingly, first flatus time postoperatively, visual analog scale (VAS) score of patients was positively correlated with the perioperative difference NLR or PLR. Moreover, we discovered that the perioperative difference NLR or PLR was correlated with elements of ERAS protocol, including first sips of water, first semifluid diet postoperatively, pelvic drain duration, and out-of-bed time of patients. Conclusion We originally reveal that certain elements of ERAS programs alleviated SIR to operation. The implementation of ERAS programs enhances postoperative recovery after gynecological surgery via improving system inflammatory status. NLR or PLR could be the novel and inexpensive marker to assess ERAS programs in gynecological surgery.Clinical trial registration:ClinicalTrials.gov, identifier, NCT03629626.
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Affiliation(s)
- Naidong Xing
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Hongyan Wang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yan Huang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jin Peng
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
- *Correspondence: Jin Peng,
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Zhao T, Zhang X, Liu X, Ren M, Cheng Y, Wang J, Luo Z. Case Report: Clinical response to anaplastic lymphoma kinase inhibitor-based targeted therapy in uterine inflammatory myofibroblastic tumor harboring ALK-IGFBP5 fusion. Front Oncol 2023; 13:1147974. [PMID: 37035208 PMCID: PMC10076585 DOI: 10.3389/fonc.2023.1147974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Background An inflammatory myofibroblastic tumor (IMT) is a mesenchymal tumor with a prevalence ranging from 0.04% to 0.7% worldwide, in which the lung is the most common predilection site, accounting for 33% of cases, followed by the abdomen, pelvis, mesentery, and uterus. Approximately 50% of uterine IMTs present as anaplastic lymphoma kinase (ALK) positive along with ALK gene fusion, which lays a solid foundation for the development of ALK-based target therapy to optimize treatment strategies. Case presentation Herein we describe a 57-year-old woman who presented with a slow-growing mass in the uterus for over 10 years and then received surgical resection because of significant progressive enlargement of the mass during follow-up. She was diagnosed with uterine leiomyosarcoma (LMS) with no further interventions until recurrence. We revised the diagnosis to uterine IMT based on diffuse ALK expression, ALK-IGFBP5 gene fusion, and the morphologic features of the tumors by pathology consultation. Based on these, we recommended an ALK tyrosine kinase inhibitor (TKI) treatment, crizotinib (250 mg bid), and she achieved a complete response (CR) with at least 18 months of progression-free survival (PFS). We monitored the dynamics of target lesions and peripheral blood cells at regular intervals through CT scans and routine blood tests during the treatment process. We present patient responses to ALK inhibitor-based targeted therapy with uterine IMT harboring ALK-IGFBP5 fusion, and the neutrophil-to-lymphocyte ratio (NLR) may be an effective indicator to predict prognosis.
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Affiliation(s)
- Ting Zhao
- Department of Gastrointestinal Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xiaowei Zhang
- Department of Gastrointestinal Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xin Liu
- Department of Head & Neck Tumors and Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Min Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yufan Cheng
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jian Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Zhiguo Luo
- Department of Gastrointestinal Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- *Correspondence: Zhiguo Luo,
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Prognostic Role of Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), Platelet-to-Lymphocyte Ratio (PLR) and Lymphocyte-to-C Reactive Protein Ratio (LCR) in Patients with Hepatocellular Carcinoma (HCC) undergoing Chemoembolizations (TACE) of the Liver: The Unexplored Corner Linking Tumor Microenvironment, Biomarkers and Interventional Radiology. Cancers (Basel) 2022; 15:cancers15010257. [PMID: 36612251 PMCID: PMC9818978 DOI: 10.3390/cancers15010257] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/04/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
TACE plays a pivotal role in hepatocellular carcinoma, from disease control to downstaging and bridging to liver transplant. Response to TACE is a surrogate marker of tumor aggressive biology, with manifold practical implications such as survival, the need for more aggressive treatments in the intermediate stage, the selection of patients on the transplant waiting list, the dropout rate from the transplant list and the post-transplant recurrence rate. Inflammation-based scores are biomarkers of the relationship between the tumor stromal microenvironment and the immune response. Investigating the connection among the tumor stromal microenvironment, biomarkers, and the response to TACE is crucial to recognize TACE refractoriness/failure, thus providing patients with tailored therapeutics. This review aims to provide a comprehensive overview of the prognostic roles of the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), the platelet-to-lymphocyte ratio (PLR), and the lymphocyte-to-C reactive protein ratio (LCR) in patients with HCC undergoing chemoembolization of the liver. Inflammation-based scores may be convenient, easily obtained, low-cost, and reliable biomarkers with prognostic significance for HCC undergoing TACE. Baseline cut-off values differ between various studies, thus increasing confusion about using of inflammation-based scores in clinical practice. Further investigations should be conducted to establish the optimal cut-off values for inflammation-based scores, consolidating their use in clinical practice.
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Tian BW, Yang YF, Yang CC, Yan LJ, Ding ZN, Liu H, Xue JS, Dong ZR, Chen ZQ, Hong JG, Wang DX, Han CL, Mao XC, Li T. Systemic immune-inflammation index predicts prognosis of cancer immunotherapy: systemic review and meta-analysis. Immunotherapy 2022; 14:1481-1496. [PMID: 36537255 DOI: 10.2217/imt-2022-0133] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: This meta-analysis was designed to explore the association between the systemic immune-inflammation index (SII) and the therapeutic effect of immune checkpoint inhibitors. Materials & methods: The authors retrieved relevant studies published before May 25, 2022. Hazard ratio (HR) with 95% CI was used to evaluate the relationship between SII and overall survival (OS) and progression-free survival (PFS). Results: 14 articles comprising 2721 patients were included in this study. The pooled results proved that high SII levels were closely related to poor prognosis in cancer patients receiving immune checkpoint inhibitors (OS HR = 2.40; 95% CI: 2.04-2.82; PFS HR = 1.57; 95% CI: 1.33-1.86) and that an SII value of 750 was appropriate as a cut-off value (OS HR = 2.20; 95% CI: 1.83-2.63; PFS HR = 1.54; 95% CI: 1.33-1.80). Conclusion: High SII levels (>750) may be an indicator of worse OS and PFS in cancer patients treated with immune checkpoint inhibitors.
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Affiliation(s)
- Bao-Wen Tian
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Ya-Fei Yang
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Chun-Cheng Yang
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Lun-Jie Yan
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Zi-Niu Ding
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Hui Liu
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Jun-Shuai Xue
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Zhao-Ru Dong
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Zhi-Qiang Chen
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Jian-Guo Hong
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Dong-Xu Wang
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Cheng-Long Han
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Xin-Cheng Mao
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, People's Republic of China
| | - Tao Li
- Department of Hepatobiliary Surgery, Second Hospital of Shandong University, Jinan, 250012, People's Republic of China
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Systemic immune-inflammation index could be associated with pseudophakic cystoid macular edema after an uneventful phacoemulsification surgery in patients without risk factors. BMC Ophthalmol 2022; 22:378. [PMID: 36131338 PMCID: PMC9494893 DOI: 10.1186/s12886-022-02606-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the association between serum biomarkers and pseudophakic cystoid macular edema (PCME) in eyes without risk factors after uneventful phacoemulsification cataract surgery. METHODS This is a case-control study. Patients without risk factors and who developed clinically significant PCME after uncomplicated phacoemulsification surgery were enrolled in the study. The age- and sex-matched control group that had normal fundus examination findings and 10/10 visual acuity in the first week, first month and following postoperative control visits was randomly recruited from the same study cohort. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were obtained from the preoperative complete blood count (CBC) test and compared between the two groups. Linear regression analysis was used to assess the relationship between central macular thickness (CMT) and biomarkers. A binary logistic regression model was generated to evaluate the significance of the biomarkers in predicting PCME. The receiver operating characteristic (ROC) curves of the significant parameters in the logistic regression model were presented to detect the area under the curve (AUC), the cut-off point, the sensitivity and the specificity. RESULTS The study cohort included 5352 patients. Of these patients, 52 (0.97%) met the inclusion criteria, and 60 age- and sex-matched patients were recruited as the control group. PLR, NLR, and SII were significantly different between the two groups (p = 0.006, p = 0.002, p < 0.001, respectively). According to the linear regression analysis, SII was found to have a significant relationship with CMT (p < 0.001). Only SII was assessed as significant in the logistic regression model (p = 0.046). In the ROC curve, the AUC of SII was 0.709. The sensitivity and specificity of SII for PCME prediction were 65.38% and 75%, respectively, and the cut-off point was 433.70. CONCLUSION SII is associated with the occurrence of PCME in eyes without risk factors after uneventful phacoemulsification surgery. SII could be a useful tool to predict PCME in eyes without risk factors.
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Li W, Deng W. Platelet-to-lymphocyte ratio predicts short-term mortality in patients with moderate to severe traumatic brain injury. Sci Rep 2022; 12:13976. [PMID: 35978006 PMCID: PMC9385644 DOI: 10.1038/s41598-022-18242-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022] Open
Abstract
An easily accessible biomarker with good diagnostic power for patients with traumatic brain injury (TBI) was needed to predict the short-term mortality. Studies have shown that platelet-to-lymphocyte ratio (PLR) is a biomarker for patients with tumor. This study aimed to identify the relationship between PLR and short-term mortality in patients with moderate to severe TBI. This is a retrospective cohort study. We selected patients with moderate to severe TBI who were admitted to the emergency department of The First Affiliated Hospital of Zhengzhou University. Biomarkers were collected within 24 h after admission. To investigate their relationship with short-term mortality, Cox proportional hazards regression and ROC curve analysis were performed. A total number of 170 patients was included. 47 (27.6%) patients had died and 123 (72.4%) patients were survived by the end of the study. Patients with different Rotterdam CT score (HR = 1.571, 95%CI 1.232–2.002, p < 0.001) or PLR levels (HR = 1.523, 95%CI 1.110–2.090, p = 0.009) had significant different mortality rates. The AUC curve analysis showed that the AUC of Rotterdam CT score and PLR groups were 0.729 (95%CI 0.638–0.821, p < 0.001) and 0.711 (95%CI 0.618–0.803 p < 0.001), respectively. PLR level is an independent biomarker with great diagnostic power for short-term mortality in patients with moderate to severe brain injury.
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Affiliation(s)
- Wenjuan Li
- Department of Neuro-Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wenjing Deng
- Department of Neuro-Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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Tunay B, Aydin S. Investigation of inflammation-related parameters in patients with candidemia hospitalized in the intensive care unit: A retrospective cohort study. Sci Prog 2022; 105:368504221124055. [PMID: 36071635 PMCID: PMC10450468 DOI: 10.1177/00368504221124055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Candidemia is the most common invasive fungal disease in intensive care units (ICUs). OBJECTIVE We aimed to investigate cases of candidemia infection developing in the ICU and factors associated with mortality due to this infection. MATERIALS AND METHODS This is a retrospective study including patients admitted to a tertiary university hospital ICU between January 2012 and December 2020. Patients over 18 years of age who had candida growth in at least one blood culture taken from central or peripheral samples (>48 h after admission to the ICU) without concurrent growth were evaluated. RESULTS The study group consisted of 136 patients with candida. Eighty-seven (63.97%) patients were male, with a median age of 69.5 (59-76.5) years. The 7-day mortality rate was 35.29%, while the 30-day mortality rate was 69.11%. As a result of multiple logistic regression analysis, after adjusting for age and malignancy, high APACHE II score and low platelet-lymphocyte ratio (PLR) - were found to be significant factors in predicting both 7-day and 30-day mortality. CONCLUSION In this study, PLR and APACHE II scores were shown to be independent predictors of mortality in patients with candidemia in the ICU.
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Affiliation(s)
- Burcu Tunay
- Department of Anesthesiology and Reanimation, Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Selda Aydin
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
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Armentano DPD, Monteiro MR, Aguiar PN, Tsukamoto JS, Pio RB, Arakelian R, Araujo RLC, Usón PLS. Laboratory variables as predictors of progression in gastroenteropancreatic neuroendocrine tumors in different lines of antineoplastic treatments. EINSTEIN-SAO PAULO 2022; 20:eAO6985. [PMID: 35674592 PMCID: PMC9165565 DOI: 10.31744/einstein_journal/2022ao6985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/21/2022] [Indexed: 11/05/2022] Open
Abstract
Objective: To determine the association of red cell blood counts, and liver panel tests to predict outcomes in patients with gastroenteropancreatic neuroendocrine tumors who underwent systemic antineoplastic treatments. Methods: Patients with gastroenteropancreatic neuroendocrine tumors in systemic treatment were assessed according to laboratory tests within the same period. Progression free survival was determined by the period between the beginning of treatment and the date of progression. We used conditional models (PWP model) to verify the association between laboratory tests and tumor progression. The level of significance used was 5%. Results: A total of 30 treatments given to 17 patients in the intention-to-treat population were evaluated. Treatment included octreotide, lanreotide, everolimus, lutetium, and chemotherapy. We had statistically significant results in chromogranin A, neutrophils and platelets-to-lymphocyte ratio. The risk of progression increases by 2% with the addition of 100ng/mL of chromogranin A (p=0.034), 4% with the increase of 100 neutrophil units (p=0.006), and 21% with the addition of 10 units in platelets-to-lymphocyte ratio (p=0.002). Conclusion: Chromogranin A, neutrophils and platelets-to-lymphocyte ratio were associated with disease progression during systemic treatment in gastroenteropancreatic neuroendocrine tumors. Further prospective studies with larger cohorts are necessary to validate our findings.
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Wu R, Li D, Zhang F, Bai Y, Wang X, Han P. Prognostic Value of Platelet-to-Lymphocyte Ratio in Non-Muscle Invasive Bladder Cancer Patients: Intravesical Bacillus Calmette-Guerin Treatment After Transurethral Resection of Bladder Tumor. Front Surg 2022; 9:907485. [PMID: 36034368 PMCID: PMC9411071 DOI: 10.3389/fsurg.2022.907485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/28/2022] [Indexed: 01/04/2023] Open
Abstract
The objective of this study was to investigate the platelet-to-lymphocyte ratio (PLR) in patients who underwent intravesical treatment for non-muscle invasive bladder cancer (NMIBC). A total of 197 patients who underwent intravesical Bacillus Calmette-Guerin treatment after transurethral resection of bladder (TURB) were included. We divided the patients into different groups according to the treatment stage before and during induction treatment as Group 1 and Group 2, and set the change value of PLR as the Group 3. The cutoff values of PLR were determined through receiver operation characteristics curves analysis. we found a significant difference in recurrence-free survival (RFS) and progression-free survival (PFS) between patients with high serum PLR and those with low serum PLR in Group 1, as well as Group 2. Cox multivariate analysis revealed that tumor number ≥3, high grade, and history of carcinoma in situ (CIS) were significant factors predicting RFS and PFS. The PLR values before and during induction therapy could be used as predictors for the progression and recurrence of NMIBC patients receiving BCG immunotherapy. the PLR values after induction therapy have a stronger predictive power.
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Wang Z, Li J, Yuan Y, Li T, Zuo M, Liu Y. Prognostic significance of preoperative systemic inflammation response index in newly diagnosed glioblastoma patients underwent gross total resection: a propensity score matching analysis. World J Surg Oncol 2022; 20:137. [PMID: 35488347 PMCID: PMC9052476 DOI: 10.1186/s12957-022-02588-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/02/2022] [Indexed: 02/08/2023] Open
Abstract
Background Glioblastoma (GBM) is the most frequent and lethal brain tumor, which possesses highly malignant characteristics and predominates in elder patients. Systemic inflammatory response index (SIRI) is a novel prognostic marker from peripheral blood, which is defined as neutrophil count × monocyte count/lymphocyte count. In the current research, we aim to explore the relationship between SIRI and newly diagnosed GBM underwent gross total resection (GTR). Methods A retrospective analysis was conducted on consecutive newly diagnosed GBM patients underwent operation at West China Hospital from March 2015 to January 2019. X-tile software was used to determine the optimal cut-off values of SIRI, and neutrophil to lymphocyte ratio (NLR). All statistical analyses were performed using SPSS software and R software. Propensity score matching (PSM) was conducted to adjust for imbalance of all potential confounding covariates. Results The current research included a total of 291 consecutive newly diagnosed GBM patients underwent gross total resection. Among them, 186 were male patients and 105 were female patients. In original cohort, only gender was evidently related to SIRI level. SIRI and NLR were independent prognostic indicators both in original cohort and PSM cohort. Prognostic models based on the independent prognostic factors were established, and prognostic capacity of Model SIRI was superior to Model NLR. Conclusion In the current research, SIRI was determined to be an independent prognostic indicator for GBM. And the prognostic predictive ability of SIRI was stronger than NLR. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02588-0.
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Affiliation(s)
- Zhihao Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Junhong Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yunbo Yuan
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Tengfei Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Mingrong Zuo
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yanhui Liu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China.
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Wei X, Chen K, Li DC, Li H, Zhu L, Wang ZG. Risk and Prognostic Factors for Small Bowel Adenocarcinoma: A Multicenter Retrospective Observational Study in China. Clin Med Insights Oncol 2022; 16:11795549221091207. [PMID: 35496501 PMCID: PMC9044781 DOI: 10.1177/11795549221091207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/13/2022] [Indexed: 11/16/2022] Open
Abstract
Background Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 3% of all gastrointestinal tumors. We evaluated the clinical characteristics, outcomes, and prognostic factors of primary SBAs. Methods We retrospectively analyzed the clinicopathological features and clinical outcomes of 300 patients with SBA from three institutions in China between January 2003 and July 2020. Overall survival (OS) was analyzed using the Kaplan-Meier method and it was statistically compared using the log-rank test. Single-variable and multivariate analyses were used to identify the significant correlates of OS. Results The primary tumor was on the duodenal papilla in 156 patients (52%), in the duodenum in 60 patients (20%), and in the jejunum-ileum in 84 patients (28%). The median OS of the entire cohort was 32.5 months (range, 0-213 months), with a 1-year OS rate of 78.0%. For jejunoileal adenocarcinoma, advanced age, advanced T stage, advanced N stage, more positive lymph nodes, distant metastasis, high carcinoembryonic antigen (CEA), and lymphocyte-to-monocyte ratio < 2.32 predicted worse survival on single-variable analysis. Multivariate analysis showed that advanced age, advanced tumor node metastases (TNM) stage, high CEA level, high alpha fetoprotein (AFP) level, and low prealbumin level were independent prognostic factors for non-ampullary SBA. The independent prognostic factors for duodenal papilla adenocarcinoma included TNM Stage III, nerve invasion, low platelet/lymphocyte ratio, and high CA19-9. Conclusion We found different independent prognostic factors for tumors at different locations. This finding warrants further investigation to ensure more effective management strategies for SBA.
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Affiliation(s)
- Xin Wei
- The General Surgery Department, The
First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke Chen
- The General Surgery Department, The
First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dong-chang Li
- The General Surgery Department, The
First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - He Li
- The Emergency Surgery, The Second
Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Liang Zhu
- The General Surgery Department, Anhui
Provincial Hospital, Hefei, China
| | - Zheng-guang Wang
- The General Surgery Department, The
First Affiliated Hospital of Anhui Medical University, Hefei, China
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Tang Y, Ji Y, Yang M. Prognostic value of pretreatment advanced lung cancer inflammation index in non-small cell lung cancer: a meta-analysis. Biomarkers 2022; 27:441-447. [PMID: 35297277 DOI: 10.1080/1354750x.2022.2055147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose To identify the prognostic value of pretreatment advanced lung cancer inflammation index (ALI) in non-small cell lung cancer (NSCLC) including surgical patients who were diagnosed with early stage. Methods The PubMed, EMBASE and Web of Science electronic databases were searched up to January 12, 2022 for relevant studies. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to assess the association between pretreatment ALI and overall survival (OS) or progression-free survival (PFS) of NSCLC patients. All statistical analyses were conducted by STATA 12.0 software. Results A total of 14 studies involving 3607 participates were included. The pooled results indicated that lower pretreatment ALI was significantly related with poorer OS (HR =2.20, 95% CI: 1.46-3.33, P<0.001) and PFS (HR =1.78, 95% CI: 1.49-2.13, P<0.001). Besides, subgroup analysis also demonstrated that lower pretreatment ALI was associated with worse OS in surgical (P<0.001) and non-metastatic (P<0.001) patients and worse PFS of surgical (P<0.001) NSCLC patients. Conclusion Pretreatment ALI was a novel and reliable prognostic indicator in NSCLC and lower pretreatment ALI predicted worse survival including patients diagnosed with early stage. However, more prospective high-quality studies are still needed to verify above findings.
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Affiliation(s)
- Yudong Tang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yanli Ji
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China School of Nursing, Sichuan University, Chengdu, 610041, P.R.China
| | - Mei Yang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China School of Nursing, Sichuan University, Chengdu, 610041, P.R.China
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Different inflammatory blood markers correlate with specific outcomes in incident HPV-negative head and neck squamous cell carcinoma: a retrospective cohort study. BMC Cancer 2022; 22:243. [PMID: 35248020 PMCID: PMC8897882 DOI: 10.1186/s12885-022-09327-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Inflammatory blood markers have been associated with oncological outcomes in several cancers, but evidence for head and neck squamous cell carcinoma (HNSCC) is scanty. Therefore, this study aims at investigating the association between five different inflammatory blood markers and several oncological outcomes.
Methods
This multi-centre retrospective analysis included 925 consecutive patients with primary HPV-negative HNSCC (median age: 68 years) diagnosed between April 2004 and June 2018, whose pre-treatment blood parameters were available. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), systemic inflammatory marker (SIM), and systemic immune-inflammation index (SII) were calculated; their associations with local, regional, and distant failure, disease-free survival (DFS), and overall survival (OS) was calculated.
Results
The median follow-up was 53 months. All five indexes were significantly associated with OS; the highest accuracy in predicting patients’ survival was found for SIM (10-year OS = 53.2% for SIM < 1.40 and 40.9% for SIM ≥ 2.46; c-index = 0.569) and LMR (10-year OS = 60.4% for LMR ≥ 3.76 and 40.5% for LMR < 2.92; c-index = 0.568). While LMR showed the strongest association with local failure (HR = 2.16; 95% CI:1.22–3.84), PLR showed the strongest association with regional (HR = 1.98; 95% CI:1.24–3.15) and distant failure (HR = 1.67; 95% CI:1.08–2.58).
Conclusion
Different inflammatory blood markers may be useful to identify patients at risk of local, regional, or distant recurrences who may benefit from treatment intensification or intensive surveillance programs.
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Chen F, Chen D, Jin L, Xu C, Zhao W, Hu W. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and C-Reactive Protein/Albumin Ratio in Luminal Breast Cancers With HER2-Negativity. Front Oncol 2022; 12:845935. [PMID: 35317078 PMCID: PMC8934412 DOI: 10.3389/fonc.2022.845935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/10/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose This study was determined to evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CAR) prior to surgery in luminal breast cancers (BC) with HER2-negativity. Methods The clinical data of 708 HER2-negative luminal BC patients from January 2013 to December 2016 were retrospectively collected and analyzed. The optimal cut-off value of NLR and CAR were determined via receiver operating characteristic (ROC) curve. The disease-free survival (DFS) and cancer specific survival (CSS) rates were estimated using the Kaplan−Meier method. Cox univariate and multivariate proportional hazards regression models were performed to identify significant predictors of DFS and CSS simultaneously. Results The mean age of the patients diagnosed was 52.43 years (range, 15–95 years), and the median follow-up was 62.71 months (range, 12-92 months). Univariate and multivariate analysis confirmed that NLR ≥2.2 was significantly associated with worse DFS (HR=2.886, 95%CI=1.756-4.745, p<0.001), and same results were obtained in terms of CSS (HR=3.999, 95%CI=2.002-7.987, p<0.001). Similarly, CAR ≥0.07 was independently and significantly associated with poor DFS (HR=3.858, 95%CI=2.346-6.345, p<0.001) and CSS (HR=6.563, 95%CI=3.558-12.106, p<0.001). Conclusion Preoperative evaluation of NLR and CAR were significant and independent prognostic indicators for luminal breast cancers with HER2-negativity.
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Affiliation(s)
| | | | | | | | - Wenhe Zhao
- *Correspondence: Wenhe Zhao, ; Wenxian Hu,
| | - Wenxian Hu
- *Correspondence: Wenhe Zhao, ; Wenxian Hu,
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Li S, Zhang G, Lu Y, Zhao T, Gao C, Liu W, Piao Y, Chen Y, Huang C, Chang A, Hao J. Perioperative Serum Scoring Systems Predict Early Recurrence and Poor Prognosis of Resectable Pancreatic Cancer. Front Oncol 2022; 12:841819. [PMID: 35265528 PMCID: PMC8900727 DOI: 10.3389/fonc.2022.841819] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/21/2022] [Indexed: 12/19/2022] Open
Abstract
Objective Some patients with pancreatic ductal adenocarcinoma (PDAC) are prone to rapid recurrence or metastasis after radical resection. However, evaluation methods for effectively identifying these patients are lacking. In this study, we established perioperative serum scoring systems to screen patients with early recurrence and poor prognosis. Methods We systematically analysed 44 perioperative serum parameters, including systemic inflammatory parameters, coagulation system parameters, tumor markers, and 18 clinicopathological characteristics of 218 patients with radical resection in our centre. Univariate Cox regression and LASSO regression models were used to screen variables. Kaplan-Meier survival analysis was used to compare relapse-free survival and overall survival. Multivariate Cox regression was used to evaluate the independent risk variables. AUC and C-index were used to reveal the effectiveness of the models. In addition, the effectiveness was also verified in an independent cohort of 109 patients. Results Preoperative systemic immune coagulation cascade (SICC) (including increased neutrophil to lymphocyte ratio, decreased lymphocyte to monocyte ratio, increased platelet and fibrinogen) and increased postoperative tumor markers (TMs) (CA199, CEA and CA242) were independent risk factors for early recurrence of resectable pancreatic cancer. On this basis, we established the preoperative SICC score and postoperative TMs score models. The patients with higher preoperative SICC or postoperative TMs score were more likely to have early relapse and worse prognosis. The nomogram based on preoperative SICC, postoperative TMs, CACI, smoking index, vascular cancer embolus and adjuvant chemotherapy can effectively evaluate the recurrence rate (AUC1 year: 0.763, AUC2 year: 0.679, AUC3 year: 0.657) and overall survival rate (AUC1 year: 0.770, AUC3 year: 0.804, AUC5 year: 0.763). Conclusion Preoperative SICC and postoperative TMs can help identify resectable PDAC patients with early recurrence and poor prognosis.
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Affiliation(s)
- Shengnan Li
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Gengpu Zhang
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Yang Lu
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Tiansuo Zhao
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Chuntao Gao
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Weishuai Liu
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Yongjun Piao
- School of Medicine, Nankai University, Tianjin, China
| | - Yanan Chen
- School of Medicine, Nankai University, Tianjin, China
| | - Chongbiao Huang
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- *Correspondence: Jihui Hao, ; Antao Chang, ; Chongbiao Huang,
| | - Antao Chang
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- *Correspondence: Jihui Hao, ; Antao Chang, ; Chongbiao Huang,
| | - Jihui Hao
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- *Correspondence: Jihui Hao, ; Antao Chang, ; Chongbiao Huang,
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Jia J, Zhang L, Wang T, Yang W, Lyu J, Zeng X, Li X, Zeng X, Liu W, Tao K, Zhang P. The association between preoperative skeletal muscle mass depletion and poor relapse-free survival in patients with gastrointestinal stromal tumors following complete resection. Nutrition 2022; 98:111636. [DOI: 10.1016/j.nut.2022.111636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/09/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
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Sheng H, Qiu Y, Xia X, Yi C, Lin J, Yang X, Huang F. Sexual Effect of Platelet-to-Lymphocyte Ratio in Predicting Cardiovascular Mortality of Peritoneal Dialysis Patients. Mediators Inflamm 2022; 2022:8760615. [PMID: 35027865 PMCID: PMC8752306 DOI: 10.1155/2022/8760615] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/09/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The study is aimed at exploring the relationship of platelet-to-lymphocyte (PLR), all-cause, and cardiovascular disease (CVD) mortality in peritoneal dialysis (PD) patients based on gender. METHODS A total of 1438 PD patients from January 1,2007 to December 31, 2014 in PD center at The First Affiliated Hospital, Sun Yat-sen University, were included. Patients were followed up until December 31, 2019. The endpoint was all-cause mortality and CVD mortality. Cox proportional hazards regression models were used to evaluate the association of PLR with all-cause and CVD mortality to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS After a median of 48.9 (interquartile range [IQR]: 23.4-79.3) months of follow-up, 406 (28.2%) patients died based on all-cause death, among which 200 (49.3%) patients died from CVD. In the multivariate Cox regression model, we found that PLR was independently related to an increased risk of CVD mortality only in female PD patients, with HR of 1.003 (95% CI: 1.001-1.006). Interaction test showed that the correlation between PLR level for all-cause and CVD mortality varied with gender (p = 0.042 and p = 0.012, respectively). CONCLUSION Higher PLR was associated with a higher risk of CVD mortality in female PD patients.
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Affiliation(s)
- Hui Sheng
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 58th, Zhongshan Road II, Guangzhou 510080, China
- Key Laboratory of Nephrology, National Health Commission of China and Guangdong Province, Guangzhou 510080, China
| | - Yagui Qiu
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 58th, Zhongshan Road II, Guangzhou 510080, China
- Key Laboratory of Nephrology, National Health Commission of China and Guangdong Province, Guangzhou 510080, China
| | - Xi Xia
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 58th, Zhongshan Road II, Guangzhou 510080, China
- Key Laboratory of Nephrology, National Health Commission of China and Guangdong Province, Guangzhou 510080, China
| | - Chunyan Yi
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 58th, Zhongshan Road II, Guangzhou 510080, China
- Key Laboratory of Nephrology, National Health Commission of China and Guangdong Province, Guangzhou 510080, China
| | - Jianxiong Lin
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 58th, Zhongshan Road II, Guangzhou 510080, China
- Key Laboratory of Nephrology, National Health Commission of China and Guangdong Province, Guangzhou 510080, China
| | - Xiao Yang
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 58th, Zhongshan Road II, Guangzhou 510080, China
- Key Laboratory of Nephrology, National Health Commission of China and Guangdong Province, Guangzhou 510080, China
| | - Fengxian Huang
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 58th, Zhongshan Road II, Guangzhou 510080, China
- Key Laboratory of Nephrology, National Health Commission of China and Guangdong Province, Guangzhou 510080, China
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Kobayashi H, Okuma T, Okajima K, Ishibashi Y, Zhang L, Hirai T, Ohki T, Ikegami M, Sawada R, Shinoda Y, Akiyama T, Goto T, Tanaka S. Systemic inflammation response index (SIRI) as a predictive factor for overall survival in advanced soft tissue sarcoma treated with eribulin. J Orthop Sci 2022; 27:222-228. [PMID: 33384219 DOI: 10.1016/j.jos.2020.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Eribulin is a tubulin and microtubule-targeting drug that has clinical benefit in overall survival (OS) for patients with advanced soft tissue sarcoma. Eribulin's efficacy has been confirmed in several clinical trials, although no clinically useful biomarkers have been identified. We therefore sought to clarify the predictive factor of eribulin treatment, while focusing on systemic inflammation and immune response values. METHODS This study included 33 advanced STS patients treated with eribulin between March 2016 and September 2019. We evaluated the associations of clinical factors influencing the efficacy of eribulin treatment and systemic inflammatory and immune response, including the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the lymphocyte-to-monocyte ratio (LMR), the systemic inflammation response index (SIRI), and the prognostic nutrition index (PNI), with progression-free survival (PFS) and OS using the Kaplan-Meier method and log-rank test. RESULTS NLR, LMR, PLR, SIRI, and PNI were unassociated with PFS. Compared with patients with SIRI <1.5, those with an SIRI ≥1.5 had a significantly shorter OS [median OS 15 months (95% confidence interval [CI] 8-not reached) vs. 7 months (95% CI 3-14), P = 0.04]. Moreover, the PFS tended to be shorter for patients with SIRI ≥1.5 who received chemotherapy after eribulin treatment than in those with SIRI >1.5 [median PFS 92.5 days (95% CI 27-204) vs. 133 days (95% CI 36-507), P = 0.08]. CONCLUSIONS High SIRI values may predict poorer overall survival and the efficacy of subsequent drugs after eribulin treatment among patients with advanced soft tissue sarcoma.
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Affiliation(s)
- Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Tomotake Okuma
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Koichi Okajima
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Yuki Ishibashi
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Liuzhe Zhang
- Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University
| | - Toshihide Hirai
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takahiro Ohki
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Masachika Ikegami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryoko Sawada
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yusuke Shinoda
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toru Akiyama
- Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University
| | - Takahiro Goto
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Abdelwahab HM, Nafea OE, Elsherif R, Gharib AF, Alrehaili AA, Abdelhamid WG. Neutrophil-to-lymphocyte ratio versus platelet-to-lymphocyte ratio in predicting clinical outcomes in acute methanol poisoning. Hum Exp Toxicol 2022; 41:9603271221102504. [PMID: 35576326 DOI: 10.1177/09603271221102504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Acute methanol poisoning is a global health concern. This study was designed to compare the prognostic roles of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and their combination in the prediction of clinical outcomes in methanol-intoxicated patients as well as to evaluate their associations with all initial patients' characteristics. We conducted a cross-sectional study among methanol-intoxicated patients. A total of 109 patients were enrolled in the study. Thirty-four (31%) patients died during hospital admission while 30 (27.5%) patients developed visual loss. Most of the unfavorable findings were evident in patients with high NLR and PLR. Neutrophil-to-lymphocyte ratio and PLR can excellently differentiate between survivors and non-survivors with an area under the curve (AUC) of 0.991 vs 0.923, respectively. Platelet-to-lymphocyte ratio showed an accepted discrimination ability to differentiate between patients who developed and patients who did not develop visual loss, AUC of 0.734, however, NLR showed no discrimination, AUC of 0.558. We concluded that NLR and PLR can serve as valuable tools in risk-stratifying patients and prognosticating outcomes in acute methanol poisoning. Platelet-to-lymphocyte ratio is superior to NLR as a predictive factor in patients with permanent visual impairment. However, a combination of NLR with PLR can develop a more powerful prediction for overall clinical outcomes.
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Affiliation(s)
- Hanan M Abdelwahab
- Poison Control Center, 68792Ain Shams University Hospitals, Cairo, Egypt
| | - Ola E Nafea
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Radwa Elsherif
- Department of Ophthalmology, Faculty of Medicine, 68792Ain Shams University, Cairo, Egypt
| | - Amal F Gharib
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, 125895Taif University, Taif, Saudi Arabia
| | - Amani A Alrehaili
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, 125895Taif University, Taif, Saudi Arabia
| | - Walaa G Abdelhamid
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, 68792Ain Shams University, Cairo, Egypt
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Sarkar S, Kannan S, Khanna P, Singh AK. Role of platelet-to-lymphocyte count ratio (PLR), as a prognostic indicator in COVID-19: A systematic review and meta-analysis. J Med Virol 2022; 94:211-221. [PMID: 34436785 PMCID: PMC8661888 DOI: 10.1002/jmv.27297] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/30/2021] [Accepted: 08/23/2021] [Indexed: 12/12/2022]
Abstract
Prognostic predictors are of paramount interest for prompt intervention and optimal utilization of the healthcare system in the ongoing context of the COVID-19 pandemic. The platelet-to-lymphocyte count ratio (PLR), has emerged as a potential tool for risk stratification of critically ill patients with sepsis. The current systematic review explores the utility of PLR as a prognostic predictor of COVID-19 patients. We screened the electronic databases until May 15, 2021 after enrolling in PROSPERO (CRD42021220269). Studies evaluating the association between PLR on admission and outcomes in terms of mortality and severity among COVID-19 patients were included. We retrieved 32 studies, with a total of 2768 and 3262 COVID-19 patients for mortality and disease severity outcomes. Deceased and critically ill patients had higher PLR levels on admission in comparison to survivors and non-severe patients (mean differences [MD] = 66.10; 95% confidence interval [CI]: 47.75-84.44; p < 0.00001 and MD = 86.74; 95% CI: 67.7-105.7; p < 0.00001, respectively). A higher level of PLR on admission in COVID-19 patients is associated with increased morbidity and mortality. However, the evidence is of low quality and further studies regarding the cut-off value of PLR are the need of the hour.
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Affiliation(s)
- Soumya Sarkar
- Department of Anaesthesia, Pain Medicine & Critical CareAIIMSAnsari NagarNew DelhiIndia
| | - Sundara Kannan
- Department of Anaesthesia, Pain Medicine & Critical CareAIIMSAnsari NagarNew DelhiIndia
| | - Puneet Khanna
- Department of Anaesthesia, Pain Medicine & Critical CareAIIMSAnsari NagarNew DelhiIndia
| | - Akhil Kant Singh
- Department of Anaesthesia, Pain Medicine & Critical CareAIIMSAnsari NagarNew DelhiIndia
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Nie L, Pan XL, Zhang XB, Zhang S, Rao JX, Su ZF. Research on the correlation of immunity in patients with chronic insomnia. Front Psychiatry 2022; 13:1034405. [PMID: 36329922 PMCID: PMC9623272 DOI: 10.3389/fpsyt.2022.1034405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the changes in immunity and clinical infection events among patients with chronic insomnia. MATERIALS AND METHODS Forty-two patients with chronic insomnia (age = 64.44 ± 10.53) and 47 normal controls (age = 67.08 ± 7.822) were selected to determine differences in data, such as complete blood counts (CBCs), biochemical indices, lymphocyte subsets, immunoglobulin (Ig), complement C3 and C4 and interleukin-6 (IL-6), as well as to compare the incidence of clinical infection between the two groups. RESULTS There were significant differences in erythrocyte, hemoglobin, hematocrit, albumin, globulin, creatinine, IgG, IgG/IgM ratio, CD4+ T-lymphocytes, CD19-lymphocytes, CD4+/CD8+ ratio, platelet/lymphocyte ratio, CD19/CD3 ratio, and clinical infection events between the chronic insomnia group and the control group (p < 0.05). There was no significant difference in neutrophil, lymphocyte, monocyte, and platelet counts; lymphocyte subsets CD8+ T and CD56+; platelet-to-lymphocyte ratio (PLR); neutrophil-to-lymphocyte ratio (NLR); complement C3; complement C4; IgM; IgA; and IL-6 between the experimental group and their controls (p > 0.05). The systolic and diastolic blood pressures of the chronic insomnia group did not vary widely from those of the controls (p > 0.05). CONCLUSION Patients with chronic insomnia have immunological abnormalities, characterized by a higher incidence of clinical infection.
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Affiliation(s)
- Li Nie
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Xian-Li Pan
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Xiao-Bao Zhang
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Shan Zhang
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Ji-Xian Rao
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Zeng-Feng Su
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
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Bilir F, Arioz DT, Vatansever N, Filiz T, Elaziz B. Hematologic parameters as a predictor of myometrial and cervical invasion in endometrial cancer. Minerva Obstet Gynecol 2021; 73:770-775. [PMID: 34905880 DOI: 10.23736/s2724-606x.21.04715-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Despite significant improvements in molecular biology for uterine cancer, we did not have specific peripheral blood biomarkers for clinical usage such as prognostic or predictive outcomes of disease in the last decade. METHODS A retrospective endometrial cancer database was collected from a tertiary gynecologic cancer center. The cohort included only endometrioid type uterine cancer. Subsequently, we investigated the relationship between preoperative hematologic parameters and pathologic findings. RESULTS In this study, 191 non-metastatic endometrial cancer (median age was 61 years, ranging from 41 to 86 years) were analyzed. Lymphocyte-to-monocyte ratio (LMR) was significantly different between the FIGO stage I and II (4.48 vs. 3.88, P=0.004). Platelet-to-lymphocyte (PLR) was significantly higher in FIGO stage III than stage I, and LMR was significantly decreased by each FIGO stage. LMR values significantly decreased with a depth of myometrial invasion. PLR and eosinophil-to-lymphocyte ratio (ELR) values were significantly higher in patients with cervical invasion compared to those without invasion, 287 vs. 144, P=0.005, 10.3 vs. 6, P=0.022, respectively. CONCLUSIONS This study revealed that low-LMR levels and high-PLR with ELR levels correlated with myometrial and cervical invasion, respectively. These findings can explain why hematologic parameters have an impact on oncologic outcomes.
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Affiliation(s)
- Filiz Bilir
- Department of Gynecologic Oncology, Afyonkarahisar Health Science University, Afyonkarahisar, Turkey -
| | - Dağıstan T Arioz
- Department of Gynecologic Oncology, Afyonkarahisar Health Science University, Afyonkarahisar, Turkey
| | - Nefize Vatansever
- Department of Gynecologic Oncology, Afyonkarahisar Health Science University, Afyonkarahisar, Turkey
| | - Tarık Filiz
- Department of Gynecologic Oncology, Afyonkarahisar Health Science University, Afyonkarahisar, Turkey
| | - Burçin Elaziz
- Department of Gynecologic Oncology, Afyonkarahisar Health Science University, Afyonkarahisar, Turkey
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Ertekin B, Yortanlı M, Özelbaykal O, Doğru A, Girişgin AS, Acar T. The Relationship between Routine Blood Parameters and the Prognosis of COVID-19 Patients in the Emergency Department. Emerg Med Int 2021; 2021:7489675. [PMID: 34868686 PMCID: PMC8633851 DOI: 10.1155/2021/7489675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/10/2021] [Accepted: 11/15/2021] [Indexed: 12/29/2022] Open
Abstract
The aim of this study is to investigate the routine blood parameters of COVID-19 patients at the time of admission to the emergency department and their relationship with the severity of the disease and prognosis. A total of 500 patients, who were diagnosed with severe COVID-19 and hospitalized in the intensive care unit between 01.04.2020 and 01.02.2021 in the emergency department of a pandemic hospital, were retrospectively analyzed. Demographic, clinical, and laboratory data of the patients were obtained from the hospital registry system. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were calculated using neutrophil, lymphocyte, monocyte, and platelet counts. These patients were divided into two groups: survivors and deceased. All parameters obtained from routine blood analysis were statistically compared between these two groups. While 280 out of 500 patients survived, 220 died. Of all patients, the mean age was 67 years and 51.8% were males. There was a significant difference between the two groups in terms of age, gender, length of hospital stay, need for mechanical ventilation, white blood cell, neutrophil, lymphocyte, monocyte, eosinophil, platelet counts, CRP, ferritin, procalcitonin values, NLR, MLR, and PLR (p < 0.001 for all). While NLR alone and MLR + NEU and NLR + PLR + MLR combinations had the highest AUC values (0.930, 0.947, and 0.939, respectively), MLR and PLR alone showed the lowest AUC values (0.875 and 0.797, respectively). The sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) in the prediction of death according to the cutoff values of the parameters have been determined. A significant correlation was determined between age, NLR, MLR, and PLR and duration of hospital stay (p < 0.001 for all). Routine blood parameters and NLR, MLR, and PLR can assist emergency physicians to identify the severity and early prognosis of COVID-19 patients.
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Affiliation(s)
- Birsen Ertekin
- Department of Emergency, Beyhekim Training and Research Hospital, Konya, Turkey
| | - Mehmet Yortanlı
- Department of Emergency, Numune State Hospital, Konya, Turkey
| | - Ozan Özelbaykal
- Department of Emergency, Numune State Hospital, Konya, Turkey
| | - Ali Doğru
- Department of Emergency, Numune State Hospital, Konya, Turkey
| | - A. Sadık Girişgin
- Department of Emergency, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Tarık Acar
- Department of Emergency, Beyhekim Training and Research Hospital, Konya, Turkey
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77
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Zhan C, Wang W, Chen L. Predictive significance of neutrophil-to-lymphocyte and platelet-to-lymphocyte for cytomegalovirus infection in infants less than 3 months: A retrospective study. J Clin Lab Anal 2021; 36:e24131. [PMID: 34811823 PMCID: PMC8761416 DOI: 10.1002/jcla.24131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the predictive value of the hematological parameters in the identification of human cytomegalovirus (CMV) infection in infants less than 3 months. METHODS A single-center, observational study of infants with CMV infection was conducted retrospectively. Routine blood parameters were analyzed in CMV-infected infants and controls with no differences of birthweight, sex, gestational age at birth, and date of admission. Furthermore, receiver-operating curve was used to assess the predictive value of the hematological parameters for CMV infection. RESULTS One hundred ninety cases with CMV infection were studied retrospectively. Compared with the control group, there were significant differences in the white blood cell count, neutrophil count, lymphocyte count, platelet count, hemoglobin, neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and lymphocyte-to-monocyte (LMR) for the patients with CMV infection (all p < 0.001). The best predicted values for CMV infection based on the area under the curve (AUC) were NLR and PLR with the optimal cut-off value of 0.28 and 65.36. NLR-PLR score of 0, 1, or 2 based on an elevated NLR (>0.28), an elevated PLR (>65.36), or both. NLR-PLR score for CMV infection prediction yielded higher AUC values than NLR or PLR alone (0.760 vs. 0.689, 0.689; p < 0.001). CONCLUSIONS The NLR combined with PLR is potentially useful as a predictor of CMV infection in infants less than 3 months.
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Affiliation(s)
- Canyang Zhan
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Weiyan Wang
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lihua Chen
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Liu W, Zhang F, Quan B, Li M, Lu S, Li J, Chen R, Yin X. The Prognostic Value of the Albumin to Gamma-Glutamyltransferase Ratio in Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation. DISEASE MARKERS 2021; 2021:3514827. [PMID: 34840628 PMCID: PMC8626189 DOI: 10.1155/2021/3514827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022]
Abstract
Albumin to gamma-glutamyltransferase ratio (AGR) is a newly developed biomarker for the prediction of patients' prognosis in solid tumors. The purpose of the study was to establish a novel AGR-based nomogram to predict tumor prognosis in patients with early-stage HCC undergoing radiofrequency ablation (RFA). 394 hepatocellular carcinoma (HCC) patients who had received RFA as initial treatment were classified into the training cohort and validation cohort. Independent prognostic factors were identified by univariate and multivariate analyses. The value of AGR was evaluated by the concordance index (C-index), receiver operating characteristic (ROC) curves, and likelihood ratio tests (LAT). Logistic regression and nomogram were performed to establish the pretreatment scoring model based on the clinical variables. As a result, AGR = 0.63 was identified as the best cutoff value to predict overall survival (OS) in the training cohort. According to the results of multivariate analysis, AGR was an independent indicator for OS and recurrence-free survival (RFS). In both training cohort and validation cohort, the high-AGR group showed better RFS and OS than the low-AGR group. What is more, the C-index, area under the ROC curves, and LAT χ 2 values suggested that AGR outperformed the Child-Pugh (CP) grade and albumin-bilirubin (ALBI) grade in terms of predicting OS. The AGR, AKP, and tumor size were used to establish the OS nomogram. Besides, the results of Hosmer-Lemeshow test and calibration curve analysis displayed that both nomograms in the training and validation cohorts performed well in terms of calibration. Therefore, the AGR-based nomogram can predict the postoperative prognosis of early HCC patients undergoing RFA.
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Affiliation(s)
- Wenfeng Liu
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Feng Zhang
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Bing Quan
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Miao Li
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Shenxin Lu
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Jinghuan Li
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Rongxin Chen
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Xin Yin
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
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Al-Rajhi N, Mohammed SF, Khoja HA, Al-Dehaim M, Ghebeh H. Prognostic markers compared to CD3+TIL in locally advanced nasopharyngeal carcinoma. Medicine (Baltimore) 2021; 100:e27956. [PMID: 34797353 PMCID: PMC8601301 DOI: 10.1097/md.0000000000027956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/05/2021] [Indexed: 01/05/2023] Open
Abstract
Locally advanced nasopharyngeal carcinoma (LA-NPC) is more prevalent in some geographic regions, including Saudi Arabia. Typically, Tumor-Node-Metastasis (TNM) staging is used in NPC. However, it is inadequate to assess the prognosis of LA-NPC.Therefore, we analyzed and compared several previously reported prognostic factors in LA-NPC patients, retrospectively, including CD3+tumor-infiltrating lymphocytes (TIL) and peripheral blood hemoglobin, EBV DNA copy number, ratios of albumin-to-alkaline phosphatase ratio (AAPR), neutrophils, or platelets-to-lymphocytes (NLR, PLR). The studied cohort was 83 LA-NPC patients previously recruited for a randomized phase II trial with a different aim.Univariate cox regression analysis showed no significant correlation between any of the tested variables with disease-free survival (DFS) or overall survival (OS) with the exception of low CD3+ TIL infiltration, which correlated significantly with DFS (HR = 6.7, P = <.001) and OS (HR = 9.1, P = .043). Similarly, in a validated multivariate cox regression analysis, only low CD3+ TIL correlated significantly with DFS (HR = 7.0, P < .001 for TIL) and OS (HR = 9.4, P = .040).Among tested parameters, CD3+ TIL was the only independent prognostic marker for DFS and OS in LA-NPC patients treated with CCRT. This study supports the use of CD3+TIL, over other factors, as an independent prognostic factor in LA-NPC.
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Affiliation(s)
- Nasser Al-Rajhi
- Department of Radiation Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Shamayel F. Mohammed
- Deparment of Laboratory Medicine and Pathology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hatim A. Khoja
- Deparment of Laboratory Medicine and Pathology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammad Al-Dehaim
- Department of Radiation Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hazem Ghebeh
- Stem Cell & Tissue Re-engineering Program, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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80
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Preoperative Neutrophil-to-Lymphocyte Ratio Level is a Predictor of Postoperative Fertility in Infertile Patients with Ovarian Endometrioma. Reprod Sci 2021; 29:1145-1155. [PMID: 34729718 DOI: 10.1007/s43032-021-00782-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/24/2021] [Indexed: 10/19/2022]
Abstract
To investigate the predictive efficacy of the preoperative neutrophil-lymphocyte ratio (NLR) for natural pregnancy outcome after laparoscopic cystectomy in infertile patients with ovarian endometrioma (OMA). Current evidence suggests that endometriosis likely induces local and systemic inflammatory processes. The NLR has been demonstrated to be of great utility in the diagnosis of endometriosis. However, the association between NLR and natural pregnancy outcome after laparoscopic surgery for endometriosis remains unknown. Data on infertile OMA patients undergoing laparoscopic surgery from January 2014 to October 2019 were retrospectively analyzed. Cox regression analysis was used to identify predictors of natural pregnancy outcome. A predictive model was then established using the nomogram. Among 217 patients, 115 patients (53.0%) experienced natural pregnancy after surgery. Compared with patients with pregnancy failure, those with pregnancy success had a significantly higher NLR (P < 0.05). Multivariate analysis revealed that age, least function (LF) score, and NLR were independent predictors of postoperative pregnancy (all P < 0.05). The NLA (NLR, LF score and age) scoring was then established and had a high predictive ability (AUC = 0.725). Patients were divided into three groups (low-, intermediate- and high-risk) based on the scoring, and the 1-year pregnancy rates were 43.5%, 34.4%, and 21.0%, respectively (P < 0.05). The preoperative NLR level was significantly associated with natural pregnancy outcome in infertile OMA patients after surgery. A predictive model combining NLR, LF score, and age could assist in the clinical decision-making process.
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81
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Chen L, Chen Y, Zhang L, Xue Y, Zhang S, Li X, Song H. In Gastric Cancer Patients Receiving Neoadjuvant Chemotherapy Systemic Inflammation Response Index is a Useful Prognostic Indicator. Pathol Oncol Res 2021; 27:1609811. [PMID: 34712105 PMCID: PMC8546636 DOI: 10.3389/pore.2021.1609811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022]
Abstract
Background: The preoperative systemic inflammation response index (SIRI), based on peripheral neutrophil (N), monocyte (M), and lymphocyte (L) counts, has shown mounting evidence as an effective prognostic indicator in some malignant tumors. The aim of the present study was to evaluate the prognostic significance of pre-treatment SIRI in gastric cancer patients who received neoadjuvant chemotherapy (NACT). Methods: This retrospective study comprised 107 patients with advanced gastric cancer treated with NACT between July 2007 and September 2015 in our hospital. SIRI was calculated from peripheral venous blood samples obtained prior to treatment. The best cutoff value for SIRI by receiver operating characteristic (ROC) curve was 1.2 (low SIRI <1.21, high SIRI ≥1.21). The clinical outcomes of disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan-Meier survival analysis and compared using the log-rank test. Univariate and multivariate analyses were performed by the Cox proportional hazards regression model. Results: The results demonstrated that the low SIRI group was statistically associated with gender, primary tumor site, white blood cell, neutrophil, and monocyte counts, NLR (neutrophil to lymphocyte ratio), MLR (monocyte to lymphocyte ratio), and PLR (platelet to lymphocyte ratio). The SIRI was predictive for DFS and OS by univariate and multivariate analysis; the low SIRI group had better median DFS and OS than the high SIRI group (median DFS 27.03 vs. 22.33 months, median OS 29.73 vs. 24.43 months). The DFS and OS in the low SIRI group were longer than the high SIRI group. Conclusions: SIRI may qualify as a useful, reliable, and convenient prognostic indicator in patients with advanced gastric cancer to help physicians to provide personalized prognostication for gastric cancer patients treated with NACT.
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Affiliation(s)
- Li Chen
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Yong Chen
- Department of General Surgery, Huai'an Second People's Hospital and the Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, China
| | - Lele Zhang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Yingwei Xue
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Shiwei Zhang
- Department of Oncology Surgery, The First People's Hospital of Fuyang Hangzhou, Hangzhou, China
| | - Xingrui Li
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongjiang Song
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
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82
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Yi X, Chen Q, Yang J, Jiang D, Zhu L, Liu H, Pang P, Zeng F, Chen C, Gong G, Yin H, Li B, Chen BT. CT-Based Sarcopenic Nomogram for Predicting Progressive Disease in Advanced Non-Small-Cell Lung Cancer. Front Oncol 2021; 11:643941. [PMID: 34692468 PMCID: PMC8531595 DOI: 10.3389/fonc.2021.643941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 09/24/2021] [Indexed: 12/25/2022] Open
Abstract
Background It is prudent to identify the risk for progressive disease (PD) in patients with non-small-cell lung cancer (NSCLC) who undergo platinum-based chemotherapy. The present study aimed to develop a CT imaging-based sarcopenic nomogram for predicting the risk of PD prior to chemotherapy treatment. Methods We retrospectively enrolled patients with NSCLC who underwent platinum-based chemotherapy. Imaging-based body composition parameters such as skeletal muscle index (SMI) for assessment of sarcopenia were obtained from pre-chemotherapy chest CT images at the level of the eleventh thoracic vertebral body (T11). Sarcopenic nomogram was constructed using multivariate logistic regression and performance of the nomogram was evaluated by discrimination, calibration curve, and decision curve. Results Sixty (14.7%) of the 408 patients in the study cohort developed PD during chemotherapy. The prediction nomogram for developing PD achieved a moderate efficiency with an area under the curve (AUC) of 0.75 (95% CI: 0.69-0.80) for the training cohort, and 0.76 (95%CI: 0.68-0.84) for the validation cohort, as well as a good performance of consistence (bootstrap for training cohort: 0.75 ± 0.02; validation cohort: 0.74 ± 0.06). Favorable clinical application was observed in the decision curve analysis. Conclusion Our CT-based sarcopenic nomogram showed the potential for an individualized prediction of progression for patients with NSCLC receiving platinum-based chemotherapy.
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Affiliation(s)
- Xiaoping Yi
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Changsha, China
| | - Qiurong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Xiangya School of Medicine, Central South University, Changsha, China
| | - Jingying Yang
- Xiangya School of Medicine, Central South University, Changsha, China.,Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dengke Jiang
- Department of Radiology, the Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Liping Zhu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, China
| | - Haipeng Liu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, China
| | - Peipei Pang
- Department of Pharmaceuticals Diagnosis, GE Healthcare, Hangzhou, China
| | - Feiyue Zeng
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Changyong Chen
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Guanghui Gong
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, China
| | - Hongling Yin
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, China
| | - Bin Li
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, United States
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Liu X, Yin L, Shen S, Hou Y. Inflammation and cancer: paradoxical roles in tumorigenesis and implications in immunotherapies. Genes Dis 2021; 10:151-164. [PMID: 37013041 PMCID: PMC10066281 DOI: 10.1016/j.gendis.2021.09.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/29/2021] [Accepted: 09/23/2021] [Indexed: 12/12/2022] Open
Abstract
Chronic inflammation caused by persistent infections and metabolic disorders is thought to contribute to the increased cancer risk and the accelerated cancer progression. Oppositely, acute inflammation induced by bacteria-based vaccines or that is occurring after cancer selectively inhibits cancer progression and metastasis. However, the interaction between inflammation and cancer may be more complex than the current explanations for the relationship between chronic and acute inflammation and cancer. In this review, we described the impact of inflammation on cancer on the basis of three perspectives, including inflammation with different durations (chronic and acute inflammation), different scopes (systemic and local inflammation) and different occurrence sequences (inflammation occurring after and before cancer). In addition, we also introduced bacteria/virus-based cancer immunotherapies. We perceive that inflammation may be a double-edged sword with cancer-promoting and cancer-suppressing functions in certain cases. We expect to further improve the understanding of the relationship between inflammation and cancer and provide a theoretical basis for further research on their complex interaction.
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Affiliation(s)
- Xinghan Liu
- The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, Jiangsu 210093, China
| | - Lijie Yin
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu 210093, China
| | - Sunan Shen
- The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, Jiangsu 210093, China
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu 210093, China
- Corresponding author. The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, Jiangsu 210093, China. Fax: +86 25 8968 8441.
| | - Yayi Hou
- The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, Jiangsu 210093, China
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu 210093, China
- Corresponding author. The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, Jiangsu 210093, China. Fax: +86 25 8968 8441.
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84
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Zhou Q, Dong J, Sun Q, Lu N, Pan Y, Han X. Role of neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with breast cancer receiving neoadjuvant chemotherapy: a meta-analysis. BMJ Open 2021; 11:e047957. [PMID: 34561257 PMCID: PMC8475153 DOI: 10.1136/bmjopen-2020-047957] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 09/06/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The neutrophil-to-lymphocyte ratio (NLR) is recognised as a suitable prognostic biomarker in patients with breast cancer. Nevertheless, the efficacy of this biomarker in predicting the pathological complete response (pCR) and survival in patients with breast cancer receiving neoadjuvant chemotherapy (NACT) is still controversial. This meta-analysis aimed to identify the association between baseline NLR and the prognosis of patients with breast cancer treated with NACT. DESIGN Meta-analysis. DATA SOURCES Relevant literature published before 1 May 2021 was searched using the Cochrane Library, Embase, PubMed and the Web of Science databases. ELIGIBILITY CRITERIA All studies involving patients with breast cancer treated with NACT and peripheral blood pretreatment NLR recorded as a dichotomous variable were included. DATA EXTRACTION AND SYNTHESIS Two researchers independently extracted and evaluated OR/HR and its 95% CIs of survival outcomes and clinicopathological parameters. RESULTS A total of 19 studies were identified. From each study, the impact of NLR on the pCR, OR and HR, with their 95% CIs were extracted and combined using either a random or fixed-effects model. The results indicate that a higher pCR in patients with a low NLR (OR 1.620, 95% CI 1.209 to 2.169, p<0.001). In addition, an elevated NLR predicted lower disease-free survival (HR 2.269, 95% CI 1.557 to 3.307, p<0.001) and overall survival (HR 1.691, 95% CI 1.365 to 2.096, p<0.001) in patients with breast cancer treated with NACT. CONCLUSIONS NLR is a suitable biomarker for predicting pCR and survival in patients with breast cancer receiving NACT.
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Affiliation(s)
- Qiong Zhou
- Department of Oncology, Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Jie Dong
- Department of Oncology, Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Qingqing Sun
- Department of Oncology, Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Nannan Lu
- Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, Hefei, Anhui, China
| | - Yueyin Pan
- Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, Hefei, Anhui, China
| | - Xinghua Han
- Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, Hefei, Anhui, China
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85
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Neutrophil-to-Lymphocyte Ratio (NLR) and Monocyte-to-Lymphocyte Ratio (MLR) Predict Clinical Outcome in Patients with Stage IIB Cervical Cancer. JOURNAL OF ONCOLOGY 2021; 2021:2939162. [PMID: 34539781 PMCID: PMC8443385 DOI: 10.1155/2021/2939162] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/11/2021] [Accepted: 08/10/2021] [Indexed: 12/15/2022]
Abstract
Introduction Stage IIB cervical cancer (CC) is an advanced stage CC with poor prognosis. Inflammatory response plays a crucial role in the development of CC, and systemic inflammatory indexes were related to the prognosis in several cancers. The objective of the study was to determine the prognostic value of platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), basophil-to-lymphocyte ratio (BLR), and systemic inflammation response index (SIRI) as inflammatory indexes in patients with stage IIB CC. Materials and Methods A retrospective study was performed in 260 patients with stage IIB CC. PLR, NLR, MLR, BLR, and SIRI were obtained from routine blood tests. Prognosis information of the patients was acquired from regular clinical follow-up. Recurrence and response to therapy were determined through electronic medical records (EMRs). Correlations of the inflammatory indexes with overall survival (OS), progression-free survival (PFS), recurrence, and response to therapy were analyzed using SPSS version 26.0 software. Results Receiver operating characteristic (ROC) curve analyses suggested that NLR, MLR, and SIRI had better predictive value than PLR as well as BLR in the prognosis and recurrence risk. Both univariate and multivariate survival analyses showed that higher NLR and MLR were significantly associated with shorter OS as well as PFS, whereas SIRI was not an independent predictive factor of PFS. Chi-square test results revealed that increased NLR was significantly correlated with higher recurrence rate (P=0.046), and increased MLR showed significant correlation with elevated recurrence risk (P=0.002). Univariate and binary logistic regression analyses for response to therapy indicated that elevated NLR was associated with decreased complete remission (CR) rate (P=0.031), and the P value lost statistical significance while being adjusted by tumor size (P=0.108). Conclusions For patients with stage IIB CC, both NLR and MLR are independent prognostic factors as well as risk factors for recurrence; NLR serves as a potential marker for therapeutic response.
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86
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Mushtaq MU, Shahzad M, Chaudhary SG, Luder M, Ahmed N, Abdelhakim H, Bansal R, Balusu R, DeJarnette S, Divine C, Kribs R, Shune L, Singh AK, Ganguly S, Abhyankar SH, McGuirk JP. Impact of SARS-CoV-2 in Hematopoietic Stem Cell Transplantation and Chimeric Antigen Receptor T Cell Therapy Recipients. Transplant Cell Ther 2021; 27:796.e1-796.e7. [PMID: 34256172 PMCID: PMC8272625 DOI: 10.1016/j.jtct.2021.07.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/19/2021] [Accepted: 07/05/2021] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19), a respiratory illness caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic in March 2020, and has caused more than 600,000 deaths in the United States at the time of this report. Hematopoietic stem cell transplantation (HCT) or chimeric antigen receptor T cell (CAR-T) therapy recipients have a higher risk of mortality with COVID-19 owing to profound immune dysregulation. In this study, we investigated the impact of SARS-CoV-2 in HCT/CAR-T therapy recipients. This single-center prospective study included all (n = 58) adult HCT/CAR-T recipients who were diagnosed with COVID-19 at the University of Kansas Medical Center between March 2020 and May 2021. Baseline and disease-related characteristics were ascertained from medical records. Data were analyzed using SPSS version 21 (IBM, Armonk, NY). Bivariate analyses, using the chi-square and t-test, and logistic regression analyses were conducted. The study included 58 HCT/CAR-T patients who acquired SARS-CoV-2 infection, including recipients of allogeneic HCT (n = 32), autologous HCT (n = 23), and CAR-T therapy (n = 3). The median patient age was 58 years (range, 24 to 77 years), and 64% were males. The median time from HCT/CAR-T therapy to SARS-CoV-2 infection was 17.7 months (range, 0.2 to 201.9 months), and 22% of the patients acquired SARS-CoV-2 within the first 100 days post-HCT/CAR-T therapy. The primary hematologic disorders were plasma cell (36%), myeloid (38%), and lymphoid (26%) malignancies. Myeloablative conditioning was performed in 62% of patients. Donors were autologous (45%), matched sibling (15%), matched unrelated (21%), and haploidentical (19%). Prior history of grade II-IV acute graft-versus-host disease (GVHD), active GVHD, and current immunosuppressive therapy (IST) was noted in 22%, 31%, and 36% of patients, respectively. Concurrent infections were observed in 19%. Lymphopenia (P = .049) and high serum ferritin concentration (P = .020) were associated with mortality. COVID-19 severity was mild in 50% of the patients, moderate in 22%, and severe in 28%. Clinical findings included pneumonia or abnormal chest imaging (in 50%), hypoxia (28%), intensive care unit admission (19%), and mechanical ventilation (10%). Therapies included remdesivir (in 41%), convalescent plasma (35%), dexamethasone (22%), monoclonal antibodies (19%), and tocilizumab (3%). The median duration of viral shedding (positive SARS-CoV-2 PCR) was 7.7 weeks (range, 2 to 18.7 weeks), and 2 patients had a persistent infection for >5 months post-CAR-T therapy. After a median follow-up of 6.1 months (range, 0.5-13.6 months), the mortality rate was 16% in all patients and 28% in allogeneic HCT recipients. Among 9 patients who died, the median survival after SARS-CoV-2 infection was 23 days (range, 14 to 140 days). In survivors with moderate-severe COVID-19, the median time to recovery was 4.2 weeks (range, 1.1 to 24.7 weeks). Among allogeneic HCT recipients, 5 (16%) developed subsequent pulmonary chronic GVHD necessitating systemic steroids and additional IST. Significant predictors of COVID-19 severity included allogeneic HCT (odds ratio [OR], 3.6, 95% confidence interval [CI], 1.2 to 10.8; P = .020), history of grade II-IV acute GVHD (OR, 4.6; 95% CI, 1.10 to 18.86; P = .036) and concurrent IST (OR, 5.9; 95% CI, 1.8 to 19.8; P = .004). HCT and CAR-T cell therapy recipients are at an increased risk of moderate-severe COVID-19 pneumonia and higher mortality with SARS-CoV-2 infection. Our findings confirm the need for continuing vigilance with social distancing and masks, vaccination prioritization, close monitoring, and aggressive treatment of HCT/CAR-T therapy recipients.
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Affiliation(s)
- Muhammad Umair Mushtaq
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS.
| | - Moazzam Shahzad
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Sibgha Gull Chaudhary
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Mary Luder
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Nausheen Ahmed
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Haitham Abdelhakim
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Rajat Bansal
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Ramesh Balusu
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Shaun DeJarnette
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Clint Divine
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Robert Kribs
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Leyla Shune
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Anurag K Singh
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Siddhartha Ganguly
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Sunil H Abhyankar
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Joseph P McGuirk
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
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Pitre T, Jones A, Su J, Helmeczi W, Xu G, Lee C, Shamsuddin A, Mir A, MacGregor S, Duong M, Ho T, Beauchamp MK, Costa AP, Kruisselbrink R. Inflammatory biomarkers as independent prognosticators of 28-day mortality for COVID-19 patients admitted to general medicine or ICU wards: a retrospective cohort study. Intern Emerg Med 2021; 16:1573-1582. [PMID: 33496923 PMCID: PMC7836340 DOI: 10.1007/s11739-021-02637-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/07/2021] [Indexed: 01/08/2023]
Abstract
Inflammatory biomarkers may be associated with disease severity and increased mortality in COVID-19 patients but have not been studied in North American populations. We sought to determine whether a set of commonly ordered inflammatory biomarkers can predict 28-day mortality. We analyzed a multi-centered (four) COVID-19 registry cohort from March 4th to December 7th, 2020. This cohort included COVID-19-positive patients admitted to medical wards or intensive care units. Patients presenting to the emergency department for COVID-19 symptoms and then subsequently discharged were also included. We performed Cox-regression analysis to measure whether commonly used biomarkers were associated with an increased 28-day mortality. Of 336 COVID-19-positive patients, 267 required hospital admission, and 69 were seen in the emergency room and discharged. The median age was 63 years (IQR 80-50) and the female-to-male ratio was 49:51. Derivation of internally validated cut-offs suggested that C-reactive protein ≥ 78.4 mg/L, neutrophil-to-lymphocyte ratio ≥ 6.1, lymphocyte-to-white blood cell ratio < 0.127, and a modified Glasgow prognostic score equal to 2 vs. 1 or 0 were associated with the highest increased risk of 28-day mortality. We provide early estimates of cut-off values for inflammatory biomarkers and indices measured at the time of admission that may be useful to clinicians for predicting 28-day mortality in North American COVID-19 patients.
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Affiliation(s)
- Tyler Pitre
- Department of Medicine, McMaster University, Hamilton, Canada.
- Waterloo regional campus, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
| | - Aaron Jones
- Waterloo regional campus, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Johnny Su
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Wryan Helmeczi
- Department of Internal Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Grace Xu
- Waterloo regional campus, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Catherine Lee
- Waterloo regional campus, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Adib Shamsuddin
- Waterloo regional campus, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Adhora Mir
- Waterloo regional campus, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Sarah MacGregor
- Waterloo regional campus, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - MyLinh Duong
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Terence Ho
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Marla K Beauchamp
- Department of Medicine, McMaster University, Hamilton, Canada
- School of rehabiliation science, McMaster University, Hamilton, ON, Canada
| | - Andrew P Costa
- Department of Medicine, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Rebecca Kruisselbrink
- Department of Medicine, McMaster University, Hamilton, Canada
- Waterloo regional campus, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
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88
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Yapar A, Atalay İB, Tokgöz MA, Ulucaköy C, Güngör BŞ. Prognostic significance of the preoperative neutrophil-to-lymphocyte ratio patients with giant cell tumor of bone. Afr Health Sci 2021; 21:1250-1258. [PMID: 35222589 PMCID: PMC8843307 DOI: 10.4314/ahs.v21i3.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) in giant cell tumor of bone (GCT). Methods The patients with GCT were identified in the hospital records and pre-treatment complete blood count results were acquired retrospectively. Whether preoperative NLR lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) values had prognostic significance in predicting recurrence was evaluated by Receiver operating curve (ROC) analysis. Furthermore, the prognostic value of NLR was evaluated by Multivariable Cox Regression analysis. Results There were 96 patients with GCT. It was found that only NLR values had prognostic significance for predicting recurrence (AUC:0.647; 95% CI:0.533–0.762; P=0.021). The statistically significant cut-off value of NLR for predicting recurrence was ≥2.25. NLR was ≥2.25 in 51% (n = 49) of patients. Multivariable analysis showed that NLR ≥2.25 (HR=2.9, 95% CI:1.3–6.6; p=0.009) and lung metastasis (HR=7.9, 95% CI:2.2–28.2; p=0.001) were independent factors of recurrence. In patients with lung metastasis and patients with NLR ≥2.25, recurrence was observed in a sooner period (Log rank test; p=0.001; p=0.009, respectively). Conclusion Our findings showed that NLR is a new and promising inflammation-based prognostic factor in GCT patients.
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Affiliation(s)
- Aliekber Yapar
- Department of Orthopaedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - İsmail Burak Atalay
- Department of Orthopaedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Ali Tokgöz
- Department of Orthopaedics and Traumatology, Dr. Nafiz Korez Sincan State Hospital, Ankara, Turkey
| | - Coşkun Ulucaköy
- Department of Orthopaedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Bedii Şafak Güngör
- Department of Orthopaedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
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89
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Peng RR, Liang ZG, Chen KH, Li L, Qu S, Zhu XD. Nomogram Based on Lactate Dehydrogenase-to-Albumin Ratio (LAR) and Platelet-to-Lymphocyte Ratio (PLR) for Predicting Survival in Nasopharyngeal Carcinoma. J Inflamm Res 2021; 14:4019-4033. [PMID: 34447260 PMCID: PMC8385134 DOI: 10.2147/jir.s322475] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/28/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose The prognosis of inflammation-related indicators like lactate dehydrogenase/albumin ratio (LAR) and the platelet/lymphocyte ratio (PLR) in nasopharyngeal carcinoma (NPC) is not yet clear. Our objective is to establish and verify the nomogram using LAR and PLR ratio for the first time to explore the prognostic value in NPC. Patients and Methods This was a retrospective collection of 1661 patients with non-metastatic NPC admitted to our hospital from 2010 to 2017. The final variables of overall survival (OS) and progression-free survival (PFS) were selected by Cox regression analysis to establish nomograms, and the methods to verify the prediction precision and discriminative ability of the nomograms were concordance index (C index), the receiver operating characteristic (ROC) curve and calibration curve. The risk stratification was carried out through the nomograms and compared with the current staging system by the Kaplan–Meier methods. Results Multivariate Cox analysis resulted that age, plasma Epstein–Barr Virus (EBV) DNA, T stage, N stage, white blood cells (WBC), PLR and LAR were independent prognostic risk factors for OS and PFS, and sex is an independent prognostic risk factor for OS. The C-indexes of OS nomogram were 0.722 (95% CI: 0.706–0.738) and 0.747 (95% CI: 0.717–0.777) in the training cohort and validation cohort, which were statistically higher than the current 8th AJCC staging system (0.646 and 0.688). The C-indexes of PFS nomogram were 0.696 (95% CI: 0.680–0.713) and 0.690 (95% CI: 0.660–0.720), which were also statistically higher than the current 8th AJCC staging system (0.632 and 0.666). Otherwise, ROC curves and the calibration curve for probability also confirmed satisfied consistency with actual observations. Conclusion LAR is a novel useful independent factor in NPC. The proposed nomogram LAR and PLR resulted in more accurate prognostic prediction than current staging system for NPC patients.
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Affiliation(s)
- Ru-Rong Peng
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Zhong-Guo Liang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Kai-Hua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Ling Li
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Song Qu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China.,Department of Oncology, Affiliated Wu-Ming Hospital of Guangxi Medical University, Nanning, People's Republic of China
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90
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Meng Y, Long C, Huang X, Huang L, Liao L, Tang W, Liu J. Prognostic role and clinical significance of C-reactive protein-lymphocyte ratio in colorectal cancer. Bioengineered 2021; 12:5138-5148. [PMID: 34436973 PMCID: PMC8806856 DOI: 10.1080/21655979.2021.1960768] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Systemic inflammatory response (SIRS) can be used as a potential prognostic marker in patients with colorectal cancer (CRC). The purpose of this study was to examine the predictive role of the C-reactive protein (CRP)-lymphocyte ratio (CLR) in the prognosis of CRC. We retrospectively analyzed the data of CRC patients who underwent surgery from 2004 to 2019. The clinicopathological characteristics and follow-up records were analyzed. According to a cutoff value of CLR, the patients were divided into the high and low groups. Kaplan–Meier curves and Cox proportional hazards regression model were applied to assess the overall survival (OS). Clinicopathological characteristics analysis showed that gender, age, BMI, lymphocyte count, tumor location, left- and right-sided CRC, differentiation, T stage, M stage, TNM stage, carcinoembryonic antigen (CEA), CLR, CRP, and microsatellite status were found to differ significantly between the high and low CLR groups. Kaplan–Meier curves revealed that the high CLR group had a shorter OS, and the elderly or right-sided CRC patients faced a worse prognosis. Multivariate analysis suggested that age (hazard ratio [HR]:1.011, P = 0.003), differentiation (HR:1.331, P = 0.000), TNM stage (HR:2.425, P = 0.000), CEA (HR:1.001, P = 0.025), CLR (HR:1.261, P = 0.014) were significant independent prognostic factors for OS. Subgroup analysis demonstrated that females or patients not receiving postoperative adjuvant chemotherapy with high CLR might suffer a worse prognosis. Overall, CLR can be applied as a promising prognostic marker in CRC patients and has great potential in guiding clinical work.
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Affiliation(s)
- Yongsheng Meng
- Division of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, The People's Republic of China.,Guangxi Clinical Research Center for Colorectal Cancer, Nanning, The People's Republic of China
| | - Chenyan Long
- 2nd Department of General Surgery, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Hunan, The People's Republic of China
| | - Xiaoliang Huang
- Division of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, The People's Republic of China.,Guangxi Clinical Research Center for Colorectal Cancer, Nanning, The People's Republic of China
| | - Lihaoyun Huang
- Division of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, The People's Republic of China.,Guangxi Clinical Research Center for Colorectal Cancer, Nanning, The People's Republic of China
| | - Lixian Liao
- Division of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, The People's Republic of China.,Guangxi Clinical Research Center for Colorectal Cancer, Nanning, The People's Republic of China
| | - Weizhong Tang
- Division of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, The People's Republic of China.,Guangxi Clinical Research Center for Colorectal Cancer, Nanning, The People's Republic of China
| | - Jungang Liu
- Division of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, The People's Republic of China.,Guangxi Clinical Research Center for Colorectal Cancer, Nanning, The People's Republic of China
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91
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Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers (Basel) 2021; 13:cancers13174287. [PMID: 34503097 PMCID: PMC8428369 DOI: 10.3390/cancers13174287] [Citation(s) in RCA: 454] [Impact Index Per Article: 151.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Breast cancer is the most common cancer among women. It is estimated that 2.3 million new cases of BC are diagnosed globally each year. Based on mRNA gene expression levels, BC can be divided into molecular subtypes that provide insights into new treatment strategies and patient stratifications that impact the management of BC patients. This review addresses the overview on the BC epidemiology, risk factors, classification with an emphasis on molecular types, prognostic biomarkers, as well as possible treatment modalities. Abstract Breast cancer (BC) is the most frequently diagnosed cancer in women worldwide with more than 2 million new cases in 2020. Its incidence and death rates have increased over the last three decades due to the change in risk factor profiles, better cancer registration, and cancer detection. The number of risk factors of BC is significant and includes both the modifiable factors and non-modifiable factors. Currently, about 80% of patients with BC are individuals aged >50. Survival depends on both stage and molecular subtype. Invasive BCs comprise wide spectrum tumors that show a variation concerning their clinical presentation, behavior, and morphology. Based on mRNA gene expression levels, BC can be divided into molecular subtypes (Luminal A, Luminal B, HER2-enriched, and basal-like). The molecular subtypes provide insights into new treatment strategies and patient stratifications that impact the management of BC patients. The eighth edition of TNM classification outlines a new staging system for BC that, in addition to anatomical features, acknowledges biological factors. Treatment of breast cancer is complex and involves a combination of different modalities including surgery, radiotherapy, chemotherapy, hormonal therapy, or biological therapies delivered in diverse sequences.
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Affiliation(s)
- Sergiusz Łukasiewicz
- Department of Surgical Oncology, Center of Oncology of the Lublin Region St. Jana z Dukli, 20-091 Lublin, Poland; (S.Ł.); (A.S.)
| | - Marcin Czeczelewski
- Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.C.); (A.F.)
| | - Alicja Forma
- Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.C.); (A.F.)
| | - Jacek Baj
- Department of Human Anatomy, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Robert Sitarz
- Department of Surgical Oncology, Center of Oncology of the Lublin Region St. Jana z Dukli, 20-091 Lublin, Poland; (S.Ł.); (A.S.)
- Department of Human Anatomy, Medical University of Lublin, 20-090 Lublin, Poland;
- Correspondence:
| | - Andrzej Stanisławek
- Department of Surgical Oncology, Center of Oncology of the Lublin Region St. Jana z Dukli, 20-091 Lublin, Poland; (S.Ł.); (A.S.)
- Department of Oncology, Chair of Oncology and Environmental Health, Medical University of Lublin, 20-081 Lublin, Poland
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92
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Sato H, Goto T, Hayashi A, Kawabata H, Okada T, Takauji S, Sasajima J, Enomoto K, Fujiya M, Oyama K, Ono Y, Sugitani A, Mizukami Y, Okumura T. Prognostic significance of skeletal muscle decrease in unresectable pancreatic cancer: Survival analysis using the Weibull exponential distribution model. Pancreatology 2021; 21:892-902. [PMID: 33722506 DOI: 10.1016/j.pan.2021.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/21/2021] [Accepted: 03/01/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVES Decrease in skeletal muscle mass and function is associated with a poor prognosis following surgical resection of pancreatic ductal adenocarcinomas (PDAs). This study evaluated whether skeletal muscle mass decrease affects PDA outcomes. METHODS Data of 112 patients with advanced and unresectable PDA who underwent chemotherapy in a single institution were retrospectively analyzed. Information on age, sex, hematological investigations, including systemic inflammation-based markers and nutritional assessment biomarkers, and imaging parameters of skeletal muscle mass and visceral adipose tissue were retrieved from the patients' medical records. The efficiency of the Cox, Weibull, and standardized exponential models were compared using hazard ratios and the Akaike Information Criterion (AIC). RESULTS Results from the Weibull, Cox, and standardized exponential model analyses indicated that low skeletal muscle mass, Eastern Cooperative Oncology Group performance status (PS), and the requirement of biliary drainage were associated with the highest risk of death, followed by carcinoembryonic antigen (CEA) levels and the presence of ascites. The AIC value from the four significant parameters was lowest for the Weibull-exponential distribution (222.3) than that of the Cox (653.7) and standardized exponential models (265.7). We developed a model for estimating the 1-year survival probability using the Weibull-exponential distribution. CONCLUSIONS Low-skeletal muscle index, PS, requirement of biliary drainage, CEA levels, and presence of ascites are independent factors for predicting poor patient survival after chemotherapy. Improved survival modeling using a parametric approach may accurately predict the outcome of patients with advanced-stage PDA.
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Affiliation(s)
- Hiroki Sato
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Takuma Goto
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Akihiro Hayashi
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Hidemasa Kawabata
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Tetsuhiro Okada
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Shuhei Takauji
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Junpei Sasajima
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Katsuro Enomoto
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Mikihiro Fujiya
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Kyohei Oyama
- Department of Cardiovascular Surgery, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
| | - Yusuke Ono
- Institute of Biomedical Research, Sapporo-Higashi Tokushukai Hospital, 3-1, North-33, East-14, Higashi-Ku, Sapporo, Japan
| | - Ayumu Sugitani
- Institute of Biomedical Research, Sapporo-Higashi Tokushukai Hospital, 3-1, North-33, East-14, Higashi-Ku, Sapporo, Japan
| | - Yusuke Mizukami
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan; Institute of Biomedical Research, Sapporo-Higashi Tokushukai Hospital, 3-1, North-33, East-14, Higashi-Ku, Sapporo, Japan.
| | - Toshikatsu Okumura
- Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan
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93
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Ito H. What is behind the elevated neutrophil to lymphocyte ratio in glucocorticoid-resistant polymyalgia rheumatica? Int J Rheum Dis 2021; 24:1217. [PMID: 34308555 DOI: 10.1111/1756-185x.14188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Hiroshi Ito
- Division of Hospital Medicine, University of Tsukuba Hospital, Tsukuba, Japan
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94
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Ao G, de Miguel M, Gomes A, Liu R, Boni V, Moreno I, Cárdenas JM, Cubillo A, Ugidos L, Calvo E. Toxicity and antitumor activity of novel agents in elderly patients with cancer included in phase 1 studies. Invest New Drugs 2021; 39:1694-1701. [PMID: 34287771 DOI: 10.1007/s10637-021-01150-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022]
Abstract
Introduction The number of cancer cases among the elderly continue to increase as the worldwide population ages. This patient subset is underrepresented in clinical trials, partly because of unresolved uncertainties about age-associated tolerabilities and antitumor activities. We reviewed phase 1 trial data to study tolerance and efficacy of novel agents used for treatment of elderly patients with cancer. Methods Data from 773 consecutive evaluable patients in 85 phase 1 clinical trials (2008-2016) at START Madrid-CIOCC were analyzed according to age, with respect to objective response, survival, and toxicity. Results The mean age was 58.7 (range: 18-87) years; 260 (33.6%) patients were >65 y (elderly group). One hundred thirty-seven (17.8%) patients received immunotherapy drugs, 308 (39.8%) received targeted agents, and 328 (42.4%) received chemotherapy. No statistically significant differences in overall survival, objective response, or severe toxicity rates were found according to treatment type. Similar toxicities and clinical activities were found between the two age subgroups; 18.8% of the elderly and 20.7% of the younger patients experienced severe hematological toxicity (p=0.5), and 30.2% and 32.7%, respectively, experienced severe non-hematological toxicity (p=0.4). Regarding antitumor activity, 12.4% of the elderly and 15% of the younger patients achieved objective responses (p=0.41). There were no significant between-group differences in overall survival (9.7 versus 11.5 months, respectively, p=0.1) or progression-free survival (2.3 versus 2.2 months, respectively, p=0.7). Conclusions This retrospective study found that elderly and younger populations had comparable antitumor activities and toxicity profiles. These results support including elderly patients with cancer in early-phase trials.
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Affiliation(s)
- Geriletu Ao
- START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain
| | - Maria de Miguel
- START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain
| | - Ana Gomes
- START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain
| | - Runhan Liu
- START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain
| | - Valentina Boni
- START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain
| | - Irene Moreno
- START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain
| | - José Miguel Cárdenas
- Departamento de Matemática Aplicada y Estadística, San Pablo CEU University. Calle Julián Romea, 18. 28003, Madrid, Spain
| | - Antonio Cubillo
- Centro Integral, Oncológico Clara Campal. Hospital Universitario HM Sanchinarro. Calle Oña, 10. 28050, Madrid, Spain.,Facultad de Medicina, Departamento de Ciencias Médicas Clínicas, Universidad CEU San Pablo. Plaza Montepríncipe, 1D, 28668, Alcorcón, Madrid, Spain
| | - Lisardo Ugidos
- Centro Integral, Oncológico Clara Campal. Hospital Universitario HM Sanchinarro. Calle Oña, 10. 28050, Madrid, Spain
| | - Emiliano Calvo
- START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain.
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95
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Peng J, Dong R, Jiao J, Liu M, Zhang X, Bu H, Dong P, Zhao S, Xing N, Feng S, Yang X, Kong B. Enhanced Recovery After Surgery Impact on the Systemic Inflammatory Response of Patients Following Gynecological Oncology Surgery: A Prospective Randomized Study. Cancer Manag Res 2021; 13:4383-4392. [PMID: 34103993 PMCID: PMC8179735 DOI: 10.2147/cmar.s294718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/29/2021] [Indexed: 12/17/2022] Open
Abstract
Objective Enhanced recovery after surgery (ERAS) protocol has widely gained acceptance in gynecological surgery. Its safety and efficacy should be evaluated fully via well-designed, randomized, control trials. The main objective of our study is to compare the ERAS protocol with the conventional perioperative care program after gynecological oncology. Furthermore, the secondary objectives of our study are the identification of markers that allow us to evaluate the effectiveness of the application of ERAS elements in the modulation of the body's response to surgical stress. Methods Patients with gynecological tumors indicated for surgery were randomly assigned to either the ERAS group or the conventional group. The ERAS protocol included short fasting time, fluid restriction, early oral feeding, reduced opioid consumption and immediate mobilization after surgery. The primary endpoint was the reduction of hospital stay in the ERAS group. The day of first flatus, postoperative nausea and vomiting (PONV), maximum pain score by the visual analogue scale (VAS) and complication, readmission rate, reoperation rate, postoperative mortality, total hospital cost and systemic inflammatory response (SIR) were secondary endpoints. Results A total of 130 patients in gynecological tumor surgery were enrolled (ERAS = 65, conventional = 65). The ERAS group had faster bowel function recovery, significantly less pain, less PONV, shorter hospital stay, and less total hospital costs. SIR markers were estimated and screened out that postoperative platelet, neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) were significantly lower in ERAS groups compared to conventional groups. Conclusion The implementation of ERAS protocol is safe and enhances postoperative recovery after gynecological oncology surgery. We firstly reveal the beneficial effect of ERAS protocols on the alleviation of postoperative SIR, which is a reflection of the magnitude of surgical trauma. Postoperative platelet, NLR or PLR could be the novel and inexpensive markers to assess how ERAS protocols modulate gynecological oncology surgery. Trial Registration The trial was registered in ClinicalTrials.gov (NCT03629626).
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Affiliation(s)
- Jin Peng
- Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Ruiying Dong
- Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Jianfen Jiao
- Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Min Liu
- Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Xi Zhang
- Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Hualei Bu
- Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Ping Dong
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, People's Republic of China
| | - Shasha Zhao
- Department of Clinical Nutrition, Qilu Hospital, Shandong University, Jinan, People's Republic of China
| | - Naidong Xing
- Department of Urology, Qilu Hospital, Shandong University, Jinan, People's Republic of China
| | - Shuai Feng
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Xingsheng Yang
- Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Beihua Kong
- Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
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Histone deacetylase inhibitor resminostat in combination with sorafenib counteracts platelet-mediated pro-tumoral effects in hepatocellular carcinoma. Sci Rep 2021; 11:9587. [PMID: 33953226 PMCID: PMC8100298 DOI: 10.1038/s41598-021-88983-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
In hepatocellular carcinoma (HCC), blood platelets have been linked to tumor growth, epithelial-to-mesenchymal transition (EMT), extrahepatic metastasis and a limited therapeutic response to the multikinase inhibitor (MKi) sorafenib, the standard of care in advanced HCC for the last decade. Recent clinical data indicated an improved overall survival for sorafenib in combination with the HDAC inhibitor resminostat in a platelet count dependent manner. Here, the impact of platelets on the sorafenib and resminostat drug effects in HCC cells was explored. In contrast to sorafenib, resminostat triggered an anti-proliferative response in HCC cell lines independent of platelets. As previously described, platelets induced invasive capabilities of HCC cells, a prerequisite for extravasation and metastasis. Importantly, the resminostat/sorafenib drug combination, but not the individual drugs, effectively blocked platelet-induced HCC cell invasion. Exploration of the molecular mechanism revealed that the combined drug action led to a reduction of platelet-induced CD44 expression and to the deregulation of several other epithelial and mesenchymal genes, suggesting interference with cell invasion via EMT. In addition, the drug combination decreased phosphorylated ERK level, indicating inhibition of the mitogenic signaling pathway MEK/ERK. Taken together, the resminostat plus sorafenib combination counteracts platelet-mediated cancer promoting effects in HCC cells.
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Dionisie V, Filip GA, Manea MC, Movileanu RC, Moisa E, Manea M, Riga S, Ciobanu AM. Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers. J Clin Med 2021; 10:1924. [PMID: 33946871 PMCID: PMC8125288 DOI: 10.3390/jcm10091924] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 12/27/2022] Open
Abstract
(1) Background: Recent research suggests inflammation as a factor involved in the pathophysiology of mood disorders. Neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), and systemic immune-inflammatory (SII) index ratios have been studied as peripheral markers of inflammation in bipolar and major depressive disorders. The purpose of this study is to comparatively analyze these inflammatory ratios among manic episodes of bipolar disorder, bipolar depression and unipolar depression. (2) Methods: 182 patients were retrospectively included in the study and divided into three groups: 65 manic patients, 34 patients with bipolar depression, and 83 unipolar depressive patients. White blood cells, neutrophils, monocytes, lymphocytes, and platelets were retrieved from the patients' database. NLR, MLR, PLR, and SII index were calculated using these parameters. (3) Results: Patients with manic episodes had elevated NLR (p < 0.001), MLR (p < 0.01), PLR (p < 0.05), and SII index (p < 0.001) compared to unipolar depression and increased NLR (p < 0.05) and SII index (p < 0.05) when compared to bipolar depression. NLR (p < 0.01) and SII index (p < 0.05) were higher in the bipolar depression than unipolar depression. NLR is an independent predictor of the bipolar type of depression in depressive patients. (4) Conclusions: The results confirm the role of inflammation in the pathophysiology of mood disorders and suggest the ability of NLR as a marker for the differentiation of bipolar from unipolar depression.
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Affiliation(s)
- Vlad Dionisie
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Gabriela Adriana Filip
- Department of Physiology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Mihnea Costin Manea
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Robert Constantin Movileanu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Emanuel Moisa
- Department of Orthopaedics, Anaesthesia and Intensive Care Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- ‘Elias’ University Emergency Hospital, 011461 Bucharest, Romania
| | - Mirela Manea
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Sorin Riga
- Department of Stress Research and Prophylaxis, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
- Neuroscience Department, Discipline of Psychiatry, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Pęksa R, Kunc M, Popęda M, Piątek M, Bieńkowski M, Żok J, Starzyńska A, Perdyan A, Sowa M, Duchnowska R, Biernat W. Combined Assessment of Immune Checkpoint Regulator VISTA on Tumor-Associated Immune Cells and Platelet-to-Lymphocyte Ratio Identifies Advanced Germ Cell Tumors with Higher Risk of Unfavorable Outcomes. Cancers (Basel) 2021; 13:cancers13081750. [PMID: 33916925 PMCID: PMC8067539 DOI: 10.3390/cancers13081750] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/16/2021] [Accepted: 04/02/2021] [Indexed: 01/15/2023] Open
Abstract
Simple Summary Testicular germ cell tumors (GCTs) are the most common malignancies in young males. The current treatment regimens are usually highly effective and curative. Nevertheless, a portion of patients presents with recurrence or succumbs due to the disease. There is an undoubtful necessity to investigate new prognostic markers to stratify the risk of such events. The current study aimed to evaluate the prognostic significance of markers of the tumor microenvironment and systemic inflammation markers in GCTs. We found that low expression of immune checkpoint proteins VISTA (V-domain Ig suppressor of T cell activation) and PD-L1 (programmed death-ligand 1) on tumor-associated immune cells and elevated inflammatory marker platelet-to-lymphocyte ratio are associated with a higher risk of events in testicular GCTs. It indicates a role of both local anti-tumor immune response and systemic inflammation in these tumors. Abstract In the current study, we aimed to investigate whether expression of immune checkpoint proteins (V-domain Ig suppressor of T cell activation (VISTA) and programmed death-ligand 1 (PD-L1)) and markers of systemic inflammation could predict progression/relapse and death in the cohort of 180 patients with testicular germ-cell tumors (GCTs). Expression of PD-L1 and VISTA was assessed by immunohistochemistry utilizing tissue microarrays. To estimate systemic inflammation neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) were calculated. We found high PD-L1 and VISTA expression on tumor-associated immune cells (TAICs) in 89 (49.44%) and 63 (37.22%) of GCTs, respectively, whereas tumor cells besides trophoblastic elements were almost uniformly negative. High PD-L1 was associated with seminomatous histology and lower stage. Relapses in stage I patients occurred predominantly in cases with low numbers of PD-L1 and VISTA-expressing TAICs. In stage II/III disease, the combination of low VISTA-expressing TAICs and high PLR was identified as predictor of shorter event-free survival (HR 4.10; 1.48–11.36, p = 0.006) and overall survival (HR 15.56, 95% CI 1.78–135.51, p = 0.001) independently of tumor histology and location of metastases. We demonstrated that the assessment of immune checkpoint proteins on TAICs may serve as a valuable prognostic factor in patients with high-risk testicular GCTs. Further study is warranted to explore the predictive utility of these biomarkers in GCTs.
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Affiliation(s)
- Rafał Pęksa
- Department of Pathomorphology, Medical University of Gdansk, 80214 Gdansk, Poland; (M.K.); (M.B.); (W.B.)
- Correspondence: ; Tel.: +48-58-349-3750
| | - Michał Kunc
- Department of Pathomorphology, Medical University of Gdansk, 80214 Gdansk, Poland; (M.K.); (M.B.); (W.B.)
| | - Marta Popęda
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdansk, 80211 Gdansk, Poland;
| | - Michał Piątek
- Department of Clinical Oncology/Chemotherapy, St Barbara Regional Specialist Hospital No 5, 41200 Sosnowiec, Poland;
| | - Michał Bieńkowski
- Department of Pathomorphology, Medical University of Gdansk, 80214 Gdansk, Poland; (M.K.); (M.B.); (W.B.)
| | - Jolanta Żok
- Department of Oncology, Regional Oncology Center in Gdansk, 80219 Gdansk, Poland;
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdansk, 80211 Gdansk, Poland;
| | - Adrian Perdyan
- Student Scientific Circle of Pathomorphology, Medical University of Gdansk, 80214 Gdansk, Poland;
| | - Marek Sowa
- Department of Urology, Medical University of Gdansk, 80214 Gdansk, Poland;
| | - Renata Duchnowska
- Department of Oncology, Military Institute in Warsaw, 01755 Warsaw, Poland;
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdansk, 80214 Gdansk, Poland; (M.K.); (M.B.); (W.B.)
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A Novel Nomogram for Survival Prediction of Patients with Spinal Metastasis From Prostate Cancer. Spine (Phila Pa 1976) 2021; 46:E364-E373. [PMID: 33620180 DOI: 10.1097/brs.0000000000003888] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective study of 84 patients with spinal metastasis from prostate cancer (SMPCa) was performed. OBJECTIVE The aim of this study was to predict the survival of patients with SMPCa by establishing an effective prognostic nomogram model, associating with the affecting factors and compare its efficacy with the existing scoring models. SUMMARY OF BACKGROUND DATA Prostate cancer (PCa) is the second most frequently malignant cancer causing death in men, and the spine is the most common site of bone metastatic burden. The aim of this study was to establish a prognostic nomogram for survival prediction of patients with SMPCa, explore associated factors, and compare the effectiveness of the new nomogram prediction model with the existing scoring systems. METHODS Included in this study were 84 SMPCa patients who were admitted in our spinal tumor center between 2006 and 2018. Their clinical data were retrospectively analyzed by univariate and multivariate analyses to identify independent variables that enabled to predict prognosis. A nomogram, named Changzheng Nomogram for Survival Prediction (CNSP), was established on the basis of preoperative independent variables, and then subjected to bootstrap re-samples for internal validation. The predictive accuracy and discriminative ability were measured by concordance index (C-index). Receiver-operating characteristic (ROC) analysis with the corresponding area under the ROC was used to estimate the prediction efficacy of CNSP and compare it with the four existing prognostic models Tomita, Tokuhashi, Bauer, and Crnalic. RESULTS A total of seven independent variables including Gleason score (P = 0.001), hormone refractory (P < 0.001), visceral metastasis (P < 0.001), lymphocyte to monocyte ratio (P = 0.009), prostate-specific antigen (P = 0.018), fPSA/tPSA (P = 0.029), Karnofsky Performance Status (P = 0.039) were identified after accurate analysis, and then entered the nomogram with the C-index of 0.87 (95% confidence interval, 0.84-0.90). The calibration curves for probability of 12-, 24-, and 36-month overall survival (OS) showed good consistency between the predictive risk and the actual risk. Compared with the previous prognostic models, the CNSP model was significantly more effective than the four existing prognostic models in predicting OS of the SMPCa patients (p < 0.05). CONCLUSION The overall performance of the CNSP model was satisfactory and could be used to estimate the survival outcome of individual patients more precisely and thus help clinicians design more specific and individualized therapeutic regimens.Level of Evidence: 4.
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Dong G, Huang A, Liu L. Platelet-to-lymphocyte ratio and prognosis in STEMI: A meta-analysis. Eur J Clin Invest 2021; 51:e13386. [PMID: 32810283 DOI: 10.1111/eci.13386] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/27/2020] [Accepted: 08/15/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Platelet-to-lymphocyte ratio (PLR) is a haematological index which reflects increased level of inflammation and thrombosis. We aimed to summarize the potential prognostic role of PLR for the in-hospital and long-term outcomes in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI) in a meta-analysis. MATERIALS AND METHODS Relevant cohort studies were identified by search the PubMed, Cochrane's Library and Embase databases. A random-effect model was applied to pool the results. In-hospital and long-term outcomes were compared between patients with higher and lower preprocedural PLR. RESULTS Eleven cohorts with 12 619 patients were included. Pooled results showed that higher preprocedural PLR was independently associated with increased risk of in-hospital major adverse cardiovascular events (MACE, risk ratio [RR]: 1.76, 95% confidence interval [CI]: 1.39 to 2.22, P < .001; I2 = 49%), cardiac mortality (RR: 1.91, 95% CI: 1.18 to 3.09, P = .009; I2 = 0), all-cause mortality (RR: 2.14, 95% CI: 1.52 to 3.01, P < .001, I2 = 24%) and no reflow after pPCI (RR: 2.22, 95% CI: 1.70 to 2.90, P < .001, I2 = 59%). Moreover, higher preprocedural PLR was associated with increased risk of MACE (RR: 1.60, 95% CI: 1.25 to 2.03, I2 = 57%, P < .001) and all-cause mortality (RR: 2.36, 95% CI: 1.53 to 3.66, I2 = 78%, P < .001) during long-term follow-up of up to 82 months after discharge. CONCLUSIONS Higher PLR predicts poor in-hospital and long-term prognosis in STEMI patients after pPCI.
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Affiliation(s)
- Guoxia Dong
- Department of General Practice, Affiliated Hospital of Jining Medical University, Jining, China
| | - Aiqin Huang
- Cardiac Care Unit, Affiliated Hospital of Jining Medical University, Jining, China
| | - Lei Liu
- Department of General Practice, Affiliated Hospital of Jining Medical University, Jining, China
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