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Murad LD, Silva TDQ, Schilithz AOC, Monteiro MC, Murad LB, Fialho E. Body Mass Index Alters the Predictive Value of the Neutrophil-to-Lymphocyte Ratio and Systemic Inflammation Response Index in Laryngeal Squamous Cell Carcinoma Patients. Nutr Cancer 2021; 74:1261-1269. [PMID: 34278900 DOI: 10.1080/01635581.2021.1952447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Laryngeal squamous cell carcinoma (LSCC) is a frequent cancer subtype among head and neck cancers. Exacerbated inflammation and nutritional deficit are common features in this type of cancer and can be used as a prognostic marker. This study aimed to investigate the relationship between body mass index (BMI), neutrophil-to-lymphocyte ratio (NLR), and systemic inflammation response index (SIRI) on overall survival (OS) of LSCC patients. In this retrospective cohort study, 168 patients were followed for 5 years. Data on clinical factors, patients' life habits, height, weight, and hematological parameters were collected. BMI, NLR, and SIRI were calculated. Pretreatment NLR≥ 2.02 and SIRI≥ 1160.85 were independent prognostic factors for poor OS. Low BMI did not significantly affect the OS. However, the inflammatory parameters had their predictive capacity altered when stratified by the BMI classification. NLR≥ 2.02 + Low BMI or SIRI≥ 1160.85 + Low BMI increased in 8.6 and 3.8 times the risk of death, respectively. In contrast, stratification by normal/high BMI classification eliminated the predictive capacity of NLR and SIRI. Here, we demonstrated the possible ability of BMI to change the prognostic capacity of inflammatory markers NLR and SIRI in patients with LSCC.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1952447.
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Affiliation(s)
- Luana Dalbem Murad
- Nutrition and Dietetics Section, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brazil.,Basic and Experimental Nutrition Department, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thays de Queiroz Silva
- Basic and Experimental Nutrition Department, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Arthur Orlando Corrêa Schilithz
- Nutrition and Dietetics Section, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brazil
| | - Mariana Costa Monteiro
- Basic and Experimental Nutrition Department, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo Borges Murad
- Nutrition and Dietetics Section, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brazil
| | - Eliane Fialho
- Basic and Experimental Nutrition Department, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Yılmaz F, Yılmaz FK, Karagöz A, Yıldırım A, Gunes HM, Akbas RB, Efe SÇ, Barutçu İ. Usefulness of neutrophil-to-lymphocyte ratio for predicting acute pericarditis outcomes. Acta Cardiol 2021; 77:422-430. [PMID: 34275415 DOI: 10.1080/00015385.2021.1951998] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND In daily practice, C-reactive protein (CRP) may be used to predict recurrence and treatment response in patients with acute pericarditis; however, the predictive role of CRP might be insufficient for clinical prediction in some patients. In this study, we aimed to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and the composite endpoint of pericarditis recurrence and/or tamponade within 1 year in patients with acute pericarditis. METHODS A total of 104 patients diagnosed with acute idiopathic pericarditis (mean age 42.8 ± 15.2 years, 55.8% male) were included in the study. Physical examination findings of these patients, electrocardiography, echocardiography, chest X-ray and laboratory findings were evaluated and analysed. During the 1-year follow-up, the composite of cardiac tamponade and/or pericarditis recurrence was investigated as the primary endpoint of the study. RESULTS Compared to the group without the composite outcome, the group with the composite outcome had significantly higher rates of moderate and severe pericardial effusion (p < 0.01) and higher white blood cell (WBC) count (p:0.001), platelet count (p = 0.003), NLR (2.14 (1.49-3.02) vs 6.60 (5.50-8.68); p < 0.001) and high-sensitivity C-reactive protein (hs-CRP) (8.01 (5.1-24.5 vs 69.5 (40.8-128); p:0.001). Higher hs-CRP (p < 0.001), WBC (p:0.001), NLR (p < 0.001) and platelets (p:0.02) were associated with pericarditis recurrence. NLR and hs-CRP were independently associated with the composite endpoint (p < 0.001 and p < 0.001, respectively). CONCLUSION NLR and hs-CRP were found to be independent predictors for the composite endpoint of tamponade and/or recurrence in acute pericarditis patients during the 1-year follow-up. Similar to hs-CRP, NLR may also be used for risk assessment in patients with idiopathic pericarditis.
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Affiliation(s)
- Fatih Yılmaz
- Kartal Kosuyolu Research and Education Hospital, Kartal, Turkey
| | | | - Ali Karagöz
- Kartal Kosuyolu Research and Education Hospital, Kartal, Turkey
| | - Arzu Yıldırım
- Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey
| | - Haci Murat Gunes
- Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey
| | | | | | - İrfan Barutçu
- Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey
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53
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Hu J, Wang L, Fan K, Ren W, Wang Q, Ruan Y, Yuan C, Huang G, He J. The Association Between Systemic Inflammatory Markers and Post-Stroke Depression: A Prospective Stroke Cohort. Clin Interv Aging 2021; 16:1231-1239. [PMID: 34234423 PMCID: PMC8243596 DOI: 10.2147/cia.s314131] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/10/2021] [Indexed: 12/12/2022] Open
Abstract
Objective Inflammation plays an important role in stroke. Many inflammatory markers in peripheral blood are proved to be associated with stroke severity or prognosis. But few comprehensive models or scales to evaluate the post-stroke depression (PSD) have been reported. In this study, we aimed to compare the level of systemic inflammation markers between PSD and non-PSD patients and explore the association of these inflammatory markers with PSD. Methods Totally, 432 ischemic stroke patients were consecutively enrolled in the study and received 1 month follow-up. We used the 17-Hamilton Rating Scale to measure depressive symptoms at 1 month after stroke. With the Hamilton Depression Scale score of >7, patients were diagnosed with PSD. Systemic immune-inflammation index (SII), neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR) and derived neutrophil-to-lymphocyte ratio (dNLR) were calculated from the admission blood work. Results Finally, 129 patients (30.5%) were diagnosed with PSD at 1 month. PSD patients showed significantly higher levels of SII (501.27 (345.43-782.58) vs 429.60 (315.64-570.98), P=0.001), NLR (2.36 (1.77-3.82) vs 2.17 (1.56-2.80), P=0.010), dNLR (1.67 (1.30-2.51) vs 1.54 (1.16-1.99), P=0.009), PLR (124.65 (95.25-155.15) vs 109.22 (92.38-142.03), P=0.015), especially SII at admission as compared to non-PSD patients. In the logistic analysis, SII value (>547.30) was independently associated with the occurrence of PSD (OR=2.181, 95% CI=1.274-3.732, p =0.004), better than dNLR (OR=1.833, 95% CI=1.071-3.137, p =0.027), PLR (OR= 1.822, 95% CI=1.063-3.122, p =0.029) and NLR (OR =1.728, 95% CI=1.009-2.958, p =0.046). Conclusion Increased SII, PLR, dNLR, NLR, particularly SII at admission, are significantly correlated with PSD and may add some prognostic clues to find early discovery of PSD.
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Affiliation(s)
- Jingjie Hu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Liuyuan Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Kaili Fan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Wenwei Ren
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Qiongzhang Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Yiting Ruan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Chengxiang Yuan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Guiqian Huang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
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Chen Y, Yang Y, Zhang XY, Fan QS, Li X, Xin YJ, Cao XJ, Wang YN, Zhou X. Nomogram Based on Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio to Predict Recurrence in Patients with Hepatocellular Carcinoma after Radiofrequency Ablation. Cardiovasc Intervent Radiol 2021; 44:1551-1560. [PMID: 34036405 DOI: 10.1007/s00270-021-02872-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 05/12/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate the prognostic value of pre-procedure neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and construct a nomogram to predict disease-free survival (DFS) in patients receiving radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) within Milan criteria. METHODS The data of 515 patients of HCC within Milan criteria receiving RFA were retrospectively collected. The patients were divided into two groups: the training group (n = 382) and the validation group (n = 133). Several preprocedural variables were analyzed in the two groups to determine the prognostic factors. RESULTS The median DFS time of the training and validation group was 28.4 months and 24.5 months, respectively. Multivariate analyses showed that number of lesions, alpha-feto protein levels, NLR and PLR were independent risk factors of DFS. According to the time-dependent receiver operating characteristic curve (t-ROC), the optimal cutoff value of the NLR and PLR was 1.55 and 75.30, respectively, with sensitivity of 0.737 and 0.648 and specificity of 0.541 and 0.508, respectively. The area under curve (AUC) of the t-ROC curves for the NLR was 0.662 and PLR was 0.597. The DFS was significantly higher in the NLR ≤ 1.55 group compared to NLR > 1.55 group and the PLR ≤ 75.30 group compared to PLR > 75.30 group in both training and validation datasets. Nomogram was developed based on the prognostic factors indicated by the Cox regression to predict 1-, 2-, 3- and 5-year DFS probabilities. CONCLUSIONS The cutoff value of the NLR and PLR was 1.55 and 75.30. This new nomogram based on NLR and PLR may provide good and individualized prediction of recurrence for HCC patients within Milan criteria after RFA.
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Affiliation(s)
- Yi Chen
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.,Department of Interventional Radiology, First Hospital of Shanxi Medical University, Shanxi Province, Taiyuan, 030001, China
| | - Yi Yang
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xin-Yuan Zhang
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Qing-Sheng Fan
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100021, China
| | - Xiao Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yu-Jing Xin
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xiao-Jing Cao
- Department of Interventional Ultrasound, China-Japan Friendship Hospital, Beijing, 100021, China
| | - Ya-Nan Wang
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xiang Zhou
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Rebuzzi SE, Signori A, Banna GL, Maruzzo M, De Giorgi U, Pedrazzoli P, Sbrana A, Zucali PA, Masini C, Naglieri E, Procopio G, Merler S, Tomasello L, Fratino L, Baldessari C, Ricotta R, Panni S, Mollica V, Sorarù M, Santoni M, Cortellini A, Prati V, Soto Parra HJ, Stellato M, Atzori F, Pignata S, Messina C, Messina M, Morelli F, Prati G, Nolè F, Vignani F, Cavo A, Roviello G, Pierantoni F, Casadei C, Bersanelli M, Chiellino S, Paolieri F, Perrino M, Brunelli M, Iacovelli R, Porta C, Buti S, Fornarini G. Inflammatory indices and clinical factors in metastatic renal cell carcinoma patients treated with nivolumab: the development of a novel prognostic score (Meet-URO 15 study). Ther Adv Med Oncol 2021; 13:17588359211019642. [PMID: 34046089 PMCID: PMC8135208 DOI: 10.1177/17588359211019642] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/05/2021] [Indexed: 02/06/2023] Open
Abstract
Background: Despite the survival advantage, not all metastatic renal cell carcinoma (mRCC) patients achieve a long-term benefit from immunotherapy. Moreover, the identification of prognostic biomarkers is still an unmet clinical need. Methods: This multicenter retrospective study investigated the prognostic role of peripheral-blood inflammatory indices and clinical factors to develop a novel prognostic score in mRCC patients receiving at least second-line nivolumab. The complete blood count before the first cycle of therapy was assessed by calculating neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), and systemic inflammation response index (SIRI). Clinical factors included pre-treatment International Metastatic RCC Database Consortium (IMDC) score, line of therapy, and metastatic sites. Results: From October 2015 to November 2019, 571 mRCC patients received nivolumab as second- and further-line treatment in 69% and 31% of cases. In univariable and multivariable analyses all inflammatory indices, IMDC score, and bone metastases significantly correlated with overall survival (OS). The multivariable model with NLR, IMDC score, and bone metastases had the highest c-index (0.697) and was chosen for the developing of the score (Schneeweiss scoring system). After internal validation (bootstrap re-sampling), the final index (Meet-URO score) composed by NLR, IMDC score, and bone metastases had a c-index of 0.691. It identified five categories with distinctive OSs: group 1 (median OS – mOS = not reached), group 2 (mOS = 43.9 months), group 3 (mOS = 22.4 months), group 4 (mOS = 10.3 months), and group 5 (mOS = 3.2 months). Moreover, the Meet-URO score allowed for a fine risk-stratification across all three IMDC groups. Conclusion: The Meet-URO score allowed for the accurate stratification of pretreated mRCC patients receiving nivolumab and is easily applicable for clinical practice at no additional cost. Future steps include its external validation, the assessment of its predictivity, and its application to first-line combinations.
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Affiliation(s)
- Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino of Genova, Largo Rosanna Benzi 10, Genova, 16132, Italy
| | - Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genova, Genova, Italy
| | - Giuseppe Luigi Banna
- Department of Oncology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK Cannizzaro Hospital, Catania, Italy
| | - Marco Maruzzo
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Sbrana
- Medical Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Paolo Andrea Zucali
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Cristina Masini
- Medical Oncology Unit, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Emanuele Naglieri
- Division of Medical Oncology, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Giuseppe Procopio
- SS Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Sara Merler
- Department of Oncology, Azienda Ospedaliera Universitaria Integrata di Verona, University of Verona,Verona, Italy
| | - Laura Tomasello
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino of Genova, Genova, Italy
| | - Lucia Fratino
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Aviano, Italy
| | - Cinzia Baldessari
- Medical Oncology Unit, Department of Oncology and Hemathology, University Hospital of Modena, Modena, Italy
| | - Riccardo Ricotta
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Stefano Panni
- Medical Oncology Unit, ASST - Istituti Ospitalieri Cremona Hospital, Cremona, Italy
| | - Veronica Mollica
- Oncologia Medica, Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Maria Sorarù
- U.O. Oncologia, Ospedale di Camposampiero, Italy
| | | | - Alessio Cortellini
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Hector Josè Soto Parra
- Department of Oncology, Medical Oncology, University Hospital Policlinico-San Marco, Catania, Italy
| | - Marco Stellato
- Department of Medical Oncology, Università Campus Bio-Medico of Roma, Rome, Italy
| | - Francesco Atzori
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Carlo Messina
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | - Marco Messina
- UOC Oncologia Medica, Istituto Fondazione G. Giglio, Cefalù, Italy
| | - Franco Morelli
- Medical Oncology Department, Casa Sollievo Della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - Giuseppe Prati
- Department of oncology and advanced technologies AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Franco Nolè
- Medical Oncology Division of Urogenital & Head & Neck Tumors, IEO, European Institute of Oncology IRCCS, Milano, Italy
| | - Francesca Vignani
- Division of Medical Oncology, Ordine Mauriziano Hospital, Torino, Italy
| | - Alessia Cavo
- Oncology Unit, Villa Scassi Hospital, Genova, Italy
| | - Giandomenico Roviello
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Firenze, Firenze, Italy
| | - Francesco Pierantoni
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Chiara Casadei
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | | | - Silvia Chiellino
- Medical Oncology Unit, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federico Paolieri
- Medical Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Matteo Perrino
- Department of Oncology, IRCCS, Humanitas Clinical and Research Center, Rozzano, Milano, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, Pathology Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Roberto Iacovelli
- Medical Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Camillo Porta
- Chair of Oncology, Department of Biomedical Sciences and Human Oncology, University of Bari 'A. Moro', Bari, Italy
| | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino of Genova, Genova, Italy
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Easier and more explanatory indices by integrating leukocyte lymphocyte ratio (LLR) and prognostic nutritional index (PNI) to IPS systems in cases with classical Hodgkin lymphoma. Leuk Res 2021; 107:106586. [PMID: 34082249 DOI: 10.1016/j.leukres.2021.106586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/11/2021] [Accepted: 04/15/2021] [Indexed: 01/04/2023]
Abstract
The aim of this study is to determine the power of he international prognostic scoring systems (IPS-7 and IPS-3) and to obtain indices by integrating leukocyte lymphocyte ratio (LLR) and prognostic nutritional index (PNI) factors as prognostic indicators in cases with classical Hodgkin lymphoma (cHL). 1012 patients with cHL were evaluated with 2 different IPS-4 scores with four parameters: stage, age, hemoglobin level, and either LLR or PNI. Statistical package SPSS v 22.0 was used. Two different Cox regression models were obtained for OS and PFS. Model 1 showed LLR ≥ 5,8 as the highest risk for OS and anemia as the highest risk for PFS. Model 2 showed PNI ≤ 45,2 as the highest risk for OS and anemia as the highest risk for PFS. IPS-4 scores obtained by integrating either LLR or PNI to IPS-3 integration of a biologic parameter either LLR or PNI need to be determined with clinical risk scoring parameters.
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Xu Q, Zhan X, Zhou Z, Li Y, Xie P, Zhang S, Li X, Yu Y, Zhou C, Zhang L, Gevaert O, Lu G. AI-based analysis of CT images for rapid triage of COVID-19 patients. NPJ Digit Med 2021; 4:75. [PMID: 33888856 PMCID: PMC8062628 DOI: 10.1038/s41746-021-00446-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/24/2021] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic overwhelms the medical resources in the stressed intensive care unit (ICU) capacity and the shortage of mechanical ventilation (MV). We performed CT-based analysis combined with electronic health records and clinical laboratory results on Cohort 1 (n = 1662 from 17 hospitals) with prognostic estimation for the rapid stratification of PCR confirmed COVID-19 patients. These models, validated on Cohort 2 (n = 700) and Cohort 3 (n = 662) constructed from nine external hospitals, achieved satisfying performance for predicting ICU, MV, and death of COVID-19 patients (AUROC 0.916, 0.919, and 0.853), even on events happened two days later after admission (AUROC 0.919, 0.943, and 0.856). Both clinical and image features showed complementary roles in prediction and provided accurate estimates to the time of progression (p < 0.001). Our findings are valuable for optimizing the use of medical resources in the COVID-19 pandemic. The models are available here: https://github.com/terryli710/COVID_19_Rapid_Triage_Risk_Predictor .
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Affiliation(s)
- Qinmei Xu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
- Stanford Center for Biomedical Informatics Research (BMIR), Department of Medicine, Stanford University, Stanford, CA, USA
| | - Xianghao Zhan
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Zhen Zhou
- Deepwise AI Lab, Deepwise Inc., Beijing, China
| | - Yiheng Li
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - Peiyi Xie
- Stanford Center for Biomedical Informatics Research (BMIR), Department of Medicine, Stanford University, Stanford, CA, USA
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shu Zhang
- Deepwise AI Lab, Deepwise Inc., Beijing, China
| | - Xiuli Li
- Deepwise AI Lab, Deepwise Inc., Beijing, China
| | - Yizhou Yu
- Deepwise AI Lab, Deepwise Inc., Beijing, China
| | - Changsheng Zhou
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Longjiang Zhang
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Olivier Gevaert
- Stanford Center for Biomedical Informatics Research (BMIR), Department of Medicine, Stanford University, Stanford, CA, USA.
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China.
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Wu M, Yang S, Feng X, Li C, Yu F, Dong J. Prognostic value of the postoperative neutrophil-lymphocyte ratio in solid tumors: A meta-analysis. PLoS One 2021; 16:e0250091. [PMID: 33872342 PMCID: PMC8055017 DOI: 10.1371/journal.pone.0250091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/30/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Numerous studies have demonstrated that a variety of systemic inflammatory markers were associated with the survival of different tumors. However, the association between elevated postoperative neutrophil-lymphocyte ratio (postNLR) and long-term outcomes, including overall survival (OS), disease-free survival (DFS), in patients with solid tumors remains controversial. A systematic review was conducted to explore the association between the postNLR and long-term outcomes in solid tumors. MATERIALS AND METHODS Relevant literature was identified using PubMed, Embase, Web of Science, and the Cochrane Library from the initiation of the databases to October 2020. Data were extracted from included studies reporting hazard ratio (HR) and 95% confidence intervals (CI), and were pooled using generic inverse-variance and random-effects modeling. 25 studies reporting on7539 patients were included in the analysis. RESULTS Elevated postNLR was associated with poor OS (HR 1.87, 95% CI = 1.53-2.28; P < 0.00001), and worse DFS (HR 1.69, 95% CI = 1.28-2.22; P = 0.0002). Subgroup analyses showed that the trend of the pooled HR for most of the subgroups was not changed, and the heterogeneity of the same tumor type was not obvious. However, there was no correlation between high postNLR obtained within 7days and poor DFS (n = 3, HR 1.25, 95CI% = 0.54-2.88; P = 0.60). CONCLUSIONS Elevated postNLR might be a readily available and inexpensive biomarker for long-term outcomes in solid tumors. Multicenter and prospective studies are needed to explore the impact of the postNLR on the prognosis of solid tumors.
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Affiliation(s)
- Meilong Wu
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
| | - Shizhong Yang
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
| | - Xiaobin Feng
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
| | - Chengquan Li
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Institute for Precision Healthcare, Tsinghua University, Haidian District, Beijing, China
| | - Fei Yu
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
| | - Jiahong Dong
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
- Institute for Precision Healthcare, Tsinghua University, Haidian District, Beijing, China
- * E-mail:
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Zhou T, Zheng N, Li X, Zhu D, Han Y. Prognostic value of neutrophil- lymphocyte count ratio (NLCR) among adult ICU patients in comparison to APACHE II score and conventional inflammatory markers: a multi center retrospective cohort study. BMC Emerg Med 2021; 21:24. [PMID: 33622247 PMCID: PMC7903782 DOI: 10.1186/s12873-021-00418-2] [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: 10/21/2020] [Accepted: 02/15/2021] [Indexed: 12/29/2022] Open
Abstract
Background Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and more precise predictor of mortality than C-reactive protein (CRP) under various medical conditions. However, large controversy remains upon this topic. To address the discrepancy, our group has compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods We performed a multi-center retrospective cohort study involving 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, CRP, serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the potential outcomes of critical illness. Then, receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results NLCR values were not different between survival and mortality groups. Meanwhile, remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels between survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more effective in predicting 28- and 7-day mortality. Conclusions NLCR is less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-021-00418-2.
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Affiliation(s)
- Tao Zhou
- Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Nan Zheng
- Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiang Li
- Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Dongmei Zhu
- Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yi Han
- Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Ma Y, Zhang J, Chen X. Lymphocyte-to-Monocyte Ratio is Associated with the Poor Prognosis of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy. Cancer Manag Res 2021; 13:1571-1580. [PMID: 33623436 PMCID: PMC7896736 DOI: 10.2147/cmar.s292048] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/31/2021] [Indexed: 12/11/2022] Open
Abstract
Purpose Systemic inflammatory cell ratio, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and lymphocyte–monocyte ratio (LMR) are used as prognostic indicators for several types of tumors. The purpose of this study was to evaluate the predictive value of inflammatory markers for pathological response and prognosis in breast cancer patients receiving neoadjuvant chemotherapy (NAC). Methods In this study, we collected data of 203 breast cancer patients who underwent surgery after receiving standard neoadjuvant therapy. The effects of NLR, PLR, and LMR on the disease-free survival (DFS) of patients with breast cancer were analyzed by χ2 test and Cox regression analyses. Results We found that 27 of the 203 patients (13.3%) had local or distant metastases. The peripheral blood NLR, PLR, and LMR areas under the curve (AUC) were 0.674 (0.555–0.793), 0.630 (0.508–0.753), and 0.773 (0.673–0.874), respectively. The optimal cutoff values were 3.0, 135, and 6.2, respectively. Univariate and multivariate analyses revealed that LMR was related to the pathological complete response (pCR) rates and breast cancer DFS (P < 0.05). Among all patients, those with low LMR, HER-2 positive, and lymph node status (N2–3) demonstrated poor DFS. Conclusion Our study thus demonstrated that LMR can act as a potential marker for predicting the efficacy and prognosis of patients with breast cancer.
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Affiliation(s)
- Youzhao Ma
- Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, People's Republic of China
| | - Jingyang Zhang
- Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, People's Republic of China
| | - Xiuchun Chen
- Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, People's Republic of China
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Ohkuma R, Kubota Y, Horiike A, Ishiguro T, Hirasawa Y, Ariizumi H, Watanabe M, Onoue R, Ando K, Tsurutani J, Yoshimura K, Aoki T, Murakami M, Kobayashi S, Tsunoda T, Wada S. The Prognostic Impact of Eosinophils and the Eosinophil-to-Lymphocyte Ratio on Survival Outcomes in Stage II Resectable Pancreatic Cancer. Pancreas 2021; 50:167-175. [PMID: 33565793 DOI: 10.1097/mpa.0000000000001731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The relationship between eosinophils and cancer prognosis is unknown. Therefore, we analyzed the relationship between circulating eosinophils and the survival of stage IIA and IIB pancreatic cancer patients who underwent surgical resection. METHODS This study included a retrospective cohort of 67 consecutive patients. Patients were categorized into two different groups based on the optimal cutoff for pretreatment levels of each biomarker, according to the receiver operating characteristic curves. RESULTS The Kaplan-Meier method showed that low eosinophil (P = 0.0403), high neutrophil (P = 0.0066), and high monocyte (P = 0.0003) counts were associated with short overall survival (OS). Low lymphocyte-to-monocyte ratio (P = 0.0194) and eosinophil-to-lymphocyte ratio (ELR) (P = 0.0413) were associated with reduced OS. In multivariate analysis, histological differentiation (P = 0.0014), high neutrophils (P = 0.047), high monocytes (P = 0.029), and low eosinophils (P < 0.0001) were correlated with poorer OS. Histological differentiation (P = 0.033), low lymphocyte-to-monocyte ratio (P = 0.029), and low ELR (P = 0.005) were correlated with poor OS and were significant independent prognostic factors of poor outcomes. CONCLUSIONS Low eosinophils and low ELR were significant independent prognostic factors of poor outcomes.
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Affiliation(s)
| | - Yutaro Kubota
- Division of Medical Oncology, Department of Medicine, School of Medicine
| | - Atsushi Horiike
- Division of Medical Oncology, Department of Medicine, School of Medicine
| | - Tomoyuki Ishiguro
- Division of Medical Oncology, Department of Medicine, School of Medicine
| | - Yuya Hirasawa
- Division of Medical Oncology, Department of Medicine, School of Medicine
| | - Hirotsugu Ariizumi
- Division of Medical Oncology, Department of Medicine, School of Medicine
| | - Makoto Watanabe
- From the Department of Clinical Diagnostic Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics
| | - Rie Onoue
- From the Department of Clinical Diagnostic Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics
| | - Kiyohiro Ando
- From the Department of Clinical Diagnostic Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics
| | | | | | - Takeshi Aoki
- Division of General and Gastroenterological Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Masahiko Murakami
- Division of General and Gastroenterological Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | | | - Takuya Tsunoda
- Division of Medical Oncology, Department of Medicine, School of Medicine
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Anwar SL, Cahyono R, Avanti WS, Budiman HY, Harahap WA, Aryandono T. Pre-treatment neutrophil-lymphocyte and platelet-lymphocyte ratios as additional markers for breast cancer progression: A retrospective cohort study. Ann Med Surg (Lond) 2021; 63:102144. [PMID: 33659054 PMCID: PMC7890158 DOI: 10.1016/j.amsu.2021.01.092] [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: 12/22/2020] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 12/20/2022] Open
Abstract
Background Breast cancer is the most prevalent cancer that causes significant morbidity and loss of productivity. Around a third of all breast cancer patients are potentially develop distant metastases albeit the current implementation of multidisciplinary treatment. A simple but effective marker to predict the risks of cancer progression is very important for clinicians to improve treatment and surveillance. Methods We recruited 1083 non-metastatic patients and analyzed the ratios of neutrophil to lymphocyte (NLR) and platelet to lymphocyte (PLR) in relation to progression-free survivals (PFS) and risks of distant metastases. Results Baseline clinicopathological variables were not significantly different in the pretreatment NLR and PLRs. Using maximum points of sensitivity and specificity of the Receiver Operating Characteristic (ROC) curve, cut-off values were determined 2.8 for NLR and 170 for PLR. Higher NLR was associated with skin and chest wall cancer infiltration (T4, P = 0.0001). Elevated PLR was associated with more advanced stages at diagnosis (P = 0.03). High NLR values were significantly associated with risks of disease progression (OR 1.555, 95% CI: 1.206–2.005, P = 0.001). Patients with high NLR had shorter PFS (34.9 vs 53.5 months, Log-rank test = 0.001) and shorter time to develop recurrent distant metastatic disease (66.6 vs 104.6 months, Log-rank test = 0.027). Conclusion High NLR is significantly associated with higher risk of disease progression and shorter time to develop metastases particularly among breast cancer patients diagnosed in the advanced stages. Elevated NLR is associated with higher risks of breast cancer disease progression. High NLR is associated with shorter time to develop distant metastases. NLR might be useful as an additional prognostic marker in breast cancer.
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Affiliation(s)
- Sumadi Lukman Anwar
- Division of Surgical Oncology - Department of Surgery, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Roby Cahyono
- Division of Surgical Oncology - Department of Surgery, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Widya Surya Avanti
- Department of Radiology, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Heru Yudhanto Budiman
- Division of Surgical Oncology - Department of Surgery, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Wirsma Arif Harahap
- Division of Surgical Oncology - Department of Surgery, Dr M Jamil Hospital / Faculty of Medicine Universitas Andalas, Padang, 25127, Indonesia
| | - Teguh Aryandono
- Division of Surgical Oncology - Department of Surgery, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
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Araki T, Tateishi K, Sonehara K, Hirota S, Komatsu M, Yamamoto M, Kanda S, Kuraishi H, Hanaoka M, Koizumi T. Clinical utility of the C-reactive protein:albumin ratio in non-small cell lung cancer patients treated with nivolumab. Thorac Cancer 2021; 12:603-612. [PMID: 33434414 PMCID: PMC7919135 DOI: 10.1111/1759-7714.13788] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Nivolumab is a second-line chemotherapy for non-small cell lung cancer (NSCLC). This study explored the impact of clinical biomarkers such as neutrophil:lymphocyte ratio (NLR), C-reactive protein:albumin ratio (CAR), and modified Glasgow prognostic score on the efficacy and outcome of nivolumab monotherapy in previously treated NSCLC patients. METHODS We retrospectively analyzed advanced or postoperative recurrence of NSCLC in 113 patients in two Japanese facilities from January 2015 to December 2019. Optimal cutoff values of NLR and CAR were assessed by the area under the receiver operating characteristic curves predicting death events to conduct regression analysis. Baseline values and values collected eight weeks after nivolumab treatment were measured to investigate time-series changes of these markers. RESULTS The patients showed median overall survival (OS) and progression-free survival (PFS) of 14.0 months and 2.3 months, respectively, with both being significantly longer in patients with partial response (PR) than in patients with progressive disease (PD). Optimal cutoff levels for NLR and CAR were 5.8 and 0.83, with significant decrease in CAR (P = 0.002) from baseline levels in PR patients and significant increase in PD patients. Baseline CAR ≥0.83 was significantly associated with one-year mortality events and overall survival (OS), and multivariate analysis showed significant association of age ≤70 years, an Eastern Cooperative Oncology Group performance status score of 2 or 3, and a baseline CAR ≥0.83 with inferior OS. CONCLUSIONS For second-line nivolumab therapy, evaluation of baseline CAR and subsequent changes in CAR may be predictive of therapeutic response to nivolumab and long-term survival in NSCLC patients. KEY POINTS Significant findings of the study The baseline value of C-reactive protein:albumin ratio was significantly associated with one-year mortality and overall survival in non-small cell lung cancer patients treated with nivolumab. What this study adds Time-series change of C-reactive protein:albumin ratio may be useful for predicting the treatment efficacy in patients treated with nivolumab.
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Affiliation(s)
- Taisuke Araki
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazunari Tateishi
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kei Sonehara
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shuko Hirota
- Japan Red Cross Society, Nagano Red Cross Hospital, Nagano, Japan
| | - Masamichi Komatsu
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Manabu Yamamoto
- Japan Red Cross Society, Nagano Red Cross Hospital, Nagano, Japan
| | - Shintaro Kanda
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Kuraishi
- Japan Red Cross Society, Nagano Red Cross Hospital, Nagano, Japan
| | - Masayuki Hanaoka
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tomonobu Koizumi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
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Uzun N, Akıncı MA. Hemogram parameters in childhood anxiety disorders: Could anxiety disorders be related with inflammation? Med Hypotheses 2020; 146:110440. [PMID: 33317847 DOI: 10.1016/j.mehy.2020.110440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 02/07/2023]
Abstract
In the etiology of anxiety disorders, immune system and inflammation are suggested to play a role. This study hypothesized that there is a relationship between anxiety disorders and inflammation. This retrospective study included 131 children and adolescents between the ages 6-17 who were diagnosed with anxiety disorders. Control group consisted of 131 healthy children with no history of psychiatric disorders or chronic inflammatory conditions. White blood cell (WBC), neutrophil (NEU), lymphocyte, monocyte, basophil, eosinophil values and other hematological markers were noted. From those values, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and other ratios were calculated. WBC and NEU values were significantly higher in children and adolescents with anxiety disorder compared to the control group. In addition, NLR, MLR and PLR values were significantly higher than the control group. Other measured parameters and calculated values did not differ between study groups. No statistically significant difference was found between Generalized Anxiety Disorder (GAD) group, Social Anxiety Disorder group and Not Otherwise Specified Anxiety Disorders (AD-NOS) group in terms of hematological markers except RDW-CV. Only RDW-CV was found statistically significantly higher in AD-NOS group compared to GAD. These results show that there is an association between inflammation and anxiety disorders. Also, it is postulated that hematological parameters can be used as a useful marker in the follow-up of patients with anxiety disorders.
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Affiliation(s)
- Necati Uzun
- Necmettin Erbakan University Meram School of Medicine, Department of Child and Adolescent Psychiatry, Konya, Turkey.
| | - Mehmet Akif Akıncı
- Dr. Ali Kemal Belviranlı Maternity and Children Hospital, Department of Child and Adolescent Psychiatry, Konya, Turkey
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Xu Q, Zhan X, Zhou Z, Li Y, Xie P, Zhang S, Li X, Yu Y, Zhou C, Zhang L, Gevaert O, Lu G. CT-based Rapid Triage of COVID-19 Patients: Risk Prediction and Progression Estimation of ICU Admission, Mechanical Ventilation, and Death of Hospitalized Patients. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 33173894 DOI: 10.1101/2020.11.04.20225797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The wave of COVID-19 continues to overwhelm the medical resources, especially the stressed intensive care unit (ICU) capacity and the shortage of mechanical ventilation (MV). Here we performed CT-based analysis combined with electronic health records and clinical laboratory results on Cohort 1 (n = 1662 from 17 hospitals) with prognostic estimation for the rapid stratification of PCR confirmed COVID-19 patients. These models, validated on Cohort 2 (n = 700) and Cohort 3 (n = 662) constructed from 9 external hospitals, achieved satisfying performance for predicting ICU, MV and death of COVID-19 patients (AUROC 0.916, 0.919 and 0.853), even on events happened two days later after admission (AUROC 0.919, 0.943 and 0.856). Both clinical and image features showed complementary roles in events prediction and provided accurate estimates to the time of progression (p<.001). Our findings are valuable for delivering timely treatment and optimizing the use of medical resources in the pandemic of COVID-19.
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Tang X, Cao Y, Liu J, Wang S, Yang Y, Du P. Diagnostic Value of Inflammatory Factors in Pathology of Bladder Cancer Patients. Front Mol Biosci 2020; 7:575483. [PMID: 33251247 PMCID: PMC7674661 DOI: 10.3389/fmolb.2020.575483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/08/2020] [Indexed: 11/13/2022] Open
Abstract
We conducted this study to evaluate the diagnostic value of Inflammatory Factors (IFs) in the pathology of bladder cancer patients. The patients who were diagnosed with urothelial bladder carcinoma (bladder cancer) and underwent surgical treatment in our center from 2014 to 2019 were enrolled. The values of Neutrophil to Lymphocyte Ratio (NLR), derived Neutrophil to Lymphocyte Ratio (dNLR), Platelet to Lymphocyte Ratio (PLR), Lymphocyte to Monocyte Ratio (LMR), Systemic Immune-inflammation Index (SII), and Prognostic Nutritional Index (PNI) were calculated by blood routine test results before operation. After obtaining the postoperative pathology of the patients, the Area Under Curve (AUC) of Receiver Operating Characteristic (ROC) curves was calculated to evaluate the diagnostic value of these IFs in pathology and their corresponding cut-off values. A total of 641 bladder cancer patients were enrolled. The median values of NLR, dNLR, PLR, LMR, SII, and PNI were 6.33, 4.09, 156.47, 2.66, 1114.29, and 51.45, respectively. Grouped patients according to the pathological grade, the NLR, dNLR, PLR, and SII of the high-grade group were significantly higher than those of the low-grade group (P < 0.001, P < 0.001, P < 0.001, and P < 0.001, respectively), while the LMR and PNI were significantly lower than those of the low-grade group (P = 0.003 and P < 0.001). Divided patients into non-muscle invasion group (Tis + Ta + T1) and muscle invasion group (T2 + T3 + T4), in which NLR, dNLR, PLR, and SII in the muscle invasion group were significantly higher than those in the non-muscle invasion group (P < 0.001, P < 0.001, P < 0.001, and P < 0.001, respectively), while LMR and PNI were significantly lower than those in the low-grade group (P = 0.012 and P < 0.001). ROC curves analyses showed that NLR, dNLR, PLR, LMR, SII, and PNI had predictive value for pathological grade (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P < 0.001, respectively) and muscle invasion (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P < 0.001, respectively). The results suggest the higher NLR, dNLR, PLR, SII, and lower LMR and PNI are associated with higher risk of high-grade and muscle invasive disease. However, this conclusion needs to be further clarified in the future.
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Affiliation(s)
- Xingxing Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Urology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yudong Cao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Urology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jia Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Urology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Shuo Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Urology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yong Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Urology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Peng Du
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Urology, Peking University Cancer Hospital & Institute, Beijing, China
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Patel A, Ravaud A, Motzer RJ, Pantuck AJ, Staehler M, Escudier B, Martini JF, Lechuga M, Lin X, George DJ. Exploratory analysis of the platelet-to-lymphocyte ratio prognostic value in the adjuvant renal cell cancer setting. Future Oncol 2020; 17:403-409. [PMID: 33028084 PMCID: PMC8488532 DOI: 10.2217/fon-2020-0652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: To examine the prognostic value of the platelet-to-lymphocyte ratio (PLR) in the adjuvant renal cell carcinoma setting. Materials & methods: Patients received adjuvant sunitinib (50 mg/day; 4 weeks on/2 weeks off) or placebo. The primary end point was disease-free survival (DFS). Results: In 609 patients, DFS was similar for baseline PLR <140 versus ≥140 overall (median: 6.4 vs 5.9 years; hazard ratio: 0.9; 95% CI: 0.7–1.2). A ≥25% decrease in PLR at week 4 overall was associated with longer DFS versus no change (hazard ratio: 0.8; 95% CI: 0.6–1.0). Conclusion: Baseline PLR was not prognostic for DFS with adjuvant sunitinib treatment in patients with renal cell carcinoma. Clinical Trials Registration: NCT00375674 (ClinicalTrials.gov)
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Affiliation(s)
| | - Alain Ravaud
- Bordeaux University Hospital, 33000 Bordeaux, France
| | - Robert J Motzer
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Allan J Pantuck
- UCLA David Geffen School of Medicine, Los Angeles, CA 90094, USA
| | | | | | | | | | - Xun Lin
- Pfizer Inc., La Jolla, CA 92121, USA
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Radulescu D, Baleanu VD, Padureanu V, Radulescu PM, Bordu S, Patrascu S, Socea B, Bacalbasa N, Surlin MV, Georgescu I, Georgescu EF. Neutrophil/Lymphocyte Ratio as Predictor of Anastomotic Leak after Gastric Cancer Surgery. Diagnostics (Basel) 2020; 10:E799. [PMID: 33050137 PMCID: PMC7601164 DOI: 10.3390/diagnostics10100799] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Neutrophil/lymphocyte ratio (NLR) is known as a prognostic for the outcome of the patients with gastric cancer. As no definite risk marker for anastomotic leakage after gastric resection was identified, we investigated the possible role of NLR. METHODS Peripheral blood count for neutrophils and lymphocytes was done at the patient's admission. We retrospectively evaluated 204 gastric cancer patients, who underwent gastric resection, comparing the values of NLR between the group of patients with anastomotic leakage and those without complications. RESULTS Using the ROC curve, we found the cutoff value of NLR, which permitted the comparison of the group with low NLR, presenting increased NLR. The cutoff value for NLR was 3.54. Between the two groups, we could observe statistically significant differences in developing fistula (p < 0.01) and complications leading to death (p < 0.025). The odds ratio for patients with NLR greater than 3.54 to develop anastomotic leak was 17.62, compared to those with lower NLR. CONCLUSION Peripheral blood NLR proved to be a predictor for anastomotic leakage.
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Affiliation(s)
- Dumitru Radulescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.R.); (V.D.B.); (M.V.S.); (I.G.); (E.F.G.)
| | - Vlad Dumitru Baleanu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.R.); (V.D.B.); (M.V.S.); (I.G.); (E.F.G.)
| | - Vlad Padureanu
- Internal Medicine Department, County Hospital of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Patricia Mihaela Radulescu
- “Victor Babes” Clinical Hospital of Infectious Diseases and Pneumophtisiology Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Silviu Bordu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.R.); (V.D.B.); (M.V.S.); (I.G.); (E.F.G.)
| | - Stefan Patrascu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.R.); (V.D.B.); (M.V.S.); (I.G.); (E.F.G.)
| | - Bogdan Socea
- General Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 021659 Bucharest, Romania
| | - Nicolae Bacalbasa
- “Dr. Ion Cantacuzino” Hospital, Gynecology Department, “Carol Davila” University of Medicine and Pharmacy, 020457 Bucharest, Romania;
| | - Marin Valeriu Surlin
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.R.); (V.D.B.); (M.V.S.); (I.G.); (E.F.G.)
| | - Ion Georgescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.R.); (V.D.B.); (M.V.S.); (I.G.); (E.F.G.)
| | - Eugen Florin Georgescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.R.); (V.D.B.); (M.V.S.); (I.G.); (E.F.G.)
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Diagnostic and Predictive Values of Inflammatory Factors in Pathology and Survival of Patients Undergoing Total Cystectomy. Mediators Inflamm 2020; 2020:9234067. [PMID: 33029106 PMCID: PMC7532356 DOI: 10.1155/2020/9234067] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/24/2020] [Accepted: 09/15/2020] [Indexed: 12/28/2022] Open
Abstract
Background Inflammation and tumorigenesis are related. We conducted this study to evaluate whether inflammatory factors (IFs) have a diagnostic value for pathology and a predictive value for survival and recurrence in bladder cancer patients undergoing total cystectomy. Methods The patients who were diagnosed with bladder cancer and underwent total cystectomy in our center from 2014 to 2020 were enrolled. The values of neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), and systemic immune-inflammation index (SII) were calculated by blood routine test results before operation. The AUC of ROC was calculated to judge the diagnostic value of the IFs in pathology and their corresponding cut-off values. For overall survival (OS) and recurrence-free survival (RFS), the above IFs were grouped according to the cut-off value. The differences between different groups were analyzed by the Kaplan-Meier curves, and the predictive value of these IFs was determined by the Cox proportional hazards regression model. Results A total of 79 patients were enrolled. All IFs had no diagnostic value for the pathological grade, tumor T stage, and systemic metastasis. Only NLR (AUC = 0.706, cut-off value = 3.12, sensitivity = 75.00%, specificity = 70.00%, P = 0.014), dNLR (AUC = 0.700, cut-off value = 2.49, sensitivity = 66.67%, specificity = 76.67%, P = 0.015), and SII (AUC = 0.704, cut-off value = 463.56, sensitivity = 100.00%, specificity = 40.00%, P = 0.004) had a diagnostic value for lymph node metastasis. The median follow-up time was 31 months, and there was no significant difference in OS between the two groups for all IFs. For RFS, Kaplan-Meier suggested PLR might be predictive when the cut-off value was 266.70 (P = 0.044), but the subsequent Cox proportional hazards regression analysis showed that all IFs had no predictive value for OS and RFS. Conclusions We found that in patients undergoing total cystectomy preoperative NLR, dNLR and SII had a diagnostic value for lymph node metastasis, while all these five IFs had no predictive value for OS and RFS. However, this conclusion needs to be further verified by large-scale studies in the future.
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Noguchi G, Nakaigawa N, Umemoto S, Kobayashi K, Shibata Y, Tsutsumi S, Yasui M, Ohtake S, Suzuki T, Osaka K, Muraoka K, Hasumi H, Kondo K, Igarashi Y, Sasada T, Kishida T, Yao M. C-reactive protein at 1 month after treatment of nivolumab as a predictive marker of efficacy in advanced renal cell carcinoma. Cancer Chemother Pharmacol 2020; 86:75-85. [PMID: 32537714 DOI: 10.1007/s00280-020-04088-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Nivolumab is part of the standard therapy for mRCC. Although deep and long-lasting responses are seen in some patients, the benefit of treatment is limited to some patients and the majority of patients will experience disease progression. PD-L1 is still under evaluation as a predictive biomarker and there is an urgent need to establish biomarkers for the treatment of nivolumab. Here, we investigate C-reactive protein (CRP) at 1 month after treatment of nivolumab as a target to predict the response of patients with metastatic renal cell carcinoma (mRCC) to nivolumab. METHODS After approval of the study by our institutional review board, 64 patients with mRCC who underwent nivolumab treatment at Kanagawa Cancer Center and Yokohama City University Hospital were enrolled. The patient characteristics, blood examination data at start of nivolumab treatment and 1 month after treatment, response to treatment and progression-free survival (PFS) were evaluated. Tumour responses were assessed according to both the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and the immune RECIST (iRECIST) criteria. Moreover, in 12 patients who agreed to an additional blood examination, several serum inflammatory factors were investigated and their correlation with CRP level was examined. RESULTS The median follow-up was 8.3 months (range 0.2-29.8 months). The median PFS period was 4.5 months and the median immune-PFS (iPFS) period was 5.3 months. RECIST 1.1 criteria underestimated the benefits of nivolumab in four (6.4%) cases. Multivariate analyses showed that an Eastern Cooperative Oncology Group performance status (≥ 2) at start of treatment and CRP level at 1 month after treatment (≥ 1.5 mg/dL) were independent risk factors for a poor iPFS of nivolumab. The CRP level at baseline was not an independent prognostic factor for iPFS. When compared with the responder group (iCR + iPR + iSD), the non-responder group (iPD) had a significantly higher CRP levels at 1 month after treatment (p < 0.001). In the responder group, there was significant decrease in the CRP level after nivolumab treatment when compared with the baseline (p = 0.002), whereas there was a significant increase in the non-responder group (p = 0.019). Even patients with high baseline CRP (≥ 1.5 mg/dL) obtained good iPFS if CRP was decreased (< 1.5 mg/dL) 1 month after treatment. In addition, the classification of Glasgow prognostic score (GPS), which is a cumulative prognostic score based on CRP and albumin, was a significant predictor for iPFS. A strong correlation (|r| > 0.7) with CRP level at 1 month after treatment was seen for sCD163, IL-34, MMP-1, MMP-2, osteopontin, sTNF-R1 and sTNF-R2. Of these, MMP-1 and MMP-2 were not correlated at baseline. CONCLUSION Our results indicated that the CRP level at 1 month after treatment with nivolumab appears to be a promising predictive biomarker for response to nivolumab treatment in patients with mRCC. It is clinically useful to be able to predict the effect within a short period. Further prospective trials are needed to prove these preliminary findings.
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Affiliation(s)
- Go Noguchi
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Noboru Nakaigawa
- Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 2360004, Japan.
| | - Susumu Umemoto
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Kota Kobayashi
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Yosuke Shibata
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Sohgo Tsutsumi
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Masato Yasui
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Shinji Ohtake
- Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 2360004, Japan
| | - Takahisa Suzuki
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Kimito Osaka
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Kentaro Muraoka
- Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 2360004, Japan
| | - Hisashi Hasumi
- Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 2360004, Japan
| | - Keiichi Kondo
- Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 2360004, Japan
| | - Yuka Igarashi
- Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Tetsuro Sasada
- Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Takeshi Kishida
- Department of Urology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 2360004, Japan
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Xu X, Dai Y, Feng L, Zhang H, Hu Y, Xu L, Zhu X, Jiang Y. Knockdown of Nav1.5 inhibits cell proliferation, migration and invasion via Wnt/β-catenin signaling pathway in oral squamous cell carcinoma. Acta Biochim Biophys Sin (Shanghai) 2020; 52:527-535. [PMID: 32400862 DOI: 10.1093/abbs/gmaa021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/14/2019] [Accepted: 03/06/2020] [Indexed: 12/19/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is a common type of malignant oral cancer that has a high recurrence rate. Voltage-gated sodium channel Nav1.5 was reported to be highly up-regulated in various types of cancers. However, the regulatory mechanism of Nav1.5 in cancers including OSCC still remains elusive. In this study, Nav1.5 was found to be highly expressed in OSCC tissues and cells. Through the analysis of clinical characteristics of patients, we found that the expression level of Nav1.5 was closely related to neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, tumor-node-metastasis stage, and lymph node metastasis. Moreover, we found that Nav1.5 mainly located on the cell membrane as well as cytoplasm and knockdown of Nav1.5 promoted cell apoptosis and decreased proliferation in OSCC. Transwell assay results showed that knockdown of Nav1.5 effectively suppressed the migration and invasion in OSCC. In addition, knockdown of Nav1.5 was found to inhibit the protein and mRNA expression levels of β-catenin, cyclin D1, and c-Myc in the Wnt/β-catenin signaling pathway. In summary, these results indicated that Nav1.5 may be involved in the progression of OSCC through the Wnt/β-catenin signaling pathway.
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Affiliation(s)
- Xiaoli Xu
- College and Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Yongzheng Dai
- Hefei School of Stomatology, Anhui Medical University, Hefei 230001, China
- Department of General Dentistry, Hefei Stomatological Hospital, Hefei 230001, China
| | - Linfei Feng
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Hongli Zhang
- College and Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Yukun Hu
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Le Xu
- Department of Stomatology, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230000, China
| | - Xinwei Zhu
- College and Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei 230032, China
- Binhu Clinical Division, Anhui Stomatology Hospital Affiliated to Anhui Medical University, Hefei 230601, China
| | - Yong Jiang
- College and Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei 230032, China
- Department of Stomatology, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230000, China
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Liu F, Zhang Q, Huang C, Shi C, Wang L, Shi N, Fang C, Shan F, Mei X, Shi J, Song F, Yang Z, Ding Z, Su X, Lu H, Zhu T, Zhang Z, Shi L, Shi Y. CT quantification of pneumonia lesions in early days predicts progression to severe illness in a cohort of COVID-19 patients. Theranostics 2020; 10:5613-5622. [PMID: 32373235 PMCID: PMC7196293 DOI: 10.7150/thno.45985] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/14/2020] [Indexed: 01/08/2023] Open
Abstract
Rationale: Some patients with coronavirus disease 2019 (COVID-19) rapidly develop respiratory failure or even die, underscoring the need for early identification of patients at elevated risk of severe illness. This study aims to quantify pneumonia lesions by computed tomography (CT) in the early days to predict progression to severe illness in a cohort of COVID-19 patients. Methods: This retrospective cohort study included confirmed COVID-19 patients. Three quantitative CT features of pneumonia lesions were automatically calculated using artificial intelligence algorithms, representing the percentages of ground-glass opacity volume (PGV), semi-consolidation volume (PSV), and consolidation volume (PCV) in both lungs. CT features, acute physiology and chronic health evaluation II (APACHE-II) score, neutrophil-to-lymphocyte ratio (NLR), and d-dimer, on day 0 (hospital admission) and day 4, were collected to predict the occurrence of severe illness within a 28-day follow-up using both logistic regression and Cox proportional hazard models. Results: We included 134 patients, of whom 19 (14.2%) developed any severe illness. CT features on day 0 and day 4, as well as their changes from day 0 to day 4, showed predictive capability. Changes in CT features from day 0 to day 4 performed the best in the prediction (area under the receiver operating characteristic curve = 0.93, 95% confidence interval [CI] 0.87~0.99; C-index=0.88, 95% CI 0.81~0.95). The hazard ratios of PGV and PCV were 1.39 (95% CI 1.05~1.84, P=0.023) and 1.67 (95% CI 1.17~2.38, P=0.005), respectively. CT features, adjusted for age and gender, on day 4 and in terms of changes from day 0 to day 4 outperformed APACHE-II, NLR, and d-dimer. Conclusions: CT quantification of pneumonia lesions can early and non-invasively predict the progression to severe illness, providing a promising prognostic indicator for clinical management of COVID-19.
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Affiliation(s)
- Fengjun Liu
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Qi Zhang
- Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai, China
- The SMART (Smart Medicine and AI-based Radiology Technology) Lab, Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, China
- School of Communication and Information Engineering, Shanghai University, Shanghai, China
- Institute of Healthcare Research, Yizhi, Shanghai, China
| | - Chao Huang
- Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai, China
- Institute of Healthcare Research, Yizhi, Shanghai, China
| | - Chunzi Shi
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lin Wang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Nannan Shi
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Cong Fang
- Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai, China
- Institute of Healthcare Research, Yizhi, Shanghai, China
| | - Fei Shan
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xue Mei
- Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jing Shi
- Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai, China
| | - Fengxiang Song
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zhongcheng Yang
- Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai, China
| | - Zezhen Ding
- Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai, China
| | - Xiaoming Su
- Institute of Healthcare Research, Yizhi, Shanghai, China
| | - Hongzhou Lu
- Department of Infectious Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Tongyu Zhu
- Department of Urology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zhiyong Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lei Shi
- Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai, China
- Institute of Healthcare Research, Yizhi, Shanghai, China
| | - Yuxin Shi
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Tang Y, Hu HQ, Tang FX, Lin D, Shen R, Deng L, Tang YL, Deng LH, Zhou M, Li J, Su B, Xu F. Combined Preoperative LMR and CA125 for Prognostic Assessment of Ovarian Cancer. J Cancer 2020; 11:3165-3171. [PMID: 32231720 PMCID: PMC7097954 DOI: 10.7150/jca.42477] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/22/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives: To investigate the role of inflammation-related factors, lymphocyte-to-monocyte ratio (LMR) alone and combined detection with cancer antigen 125 (CA125), in the prognostic assessment of ovarian cancer (OC). Methods: A retrospective clinicopathologic review was performed. The receiver-operating characteristic (ROC) curves of LMR, CA125, and COLC predicting mortality in OC patients were constructed. Besides, Kaplan-Meier and Cox logistic regression models were used to plot the survival curves and determine the independent prognostic factors. Results: A total of 214 OC patients were identified in this cohort. The mean duration of follow-up was 64 months (minimum 8 months, maximum 116 months). In this cohort, 135 cases died (63.1%), and the median progression-free survival (PFS) and overall survival (OS) were 20 and 39.5 months, respectively. Results of the multivariate Cox regression model showed that LMR≤3.8 (HR = 0.494, 95% CI: 0.329-0.742, P = 0.001) and CA125>34 U/ml (HR = 1.641, 95% CI: 1.057-2.550, P = 0.027) were significantly associated with poor PFS; and LMR≤3.8 (HR = 0.459, 95% CI: 0.306-0.688, P = <0.001) and CA125>34 U/ml (HR = 1.946, 95% CI: 1.256-3.015, P = 0.003) were significantly associated with OS. Furthermore, the area under the curve of COLC was higher (0.713) than that of LMR (0.709) or CA125 (0.583), the specificity of COLC was higher (75.9%) than that of LMR (62%) or CA125 (40.5%) in predicting mortality in OC patients. Conclusions: LMR alone and combined with CA125 might be used as predictive markers in OC. Furthermore, as a prognostic factor, COLC might have a higher specificity to predict the outcome.
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Affiliation(s)
- Ying Tang
- Department of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, PR China
| | - Hui-Quan Hu
- Department of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, PR China
| | | | - Dan Lin
- North Sichuan Medical College, Nanchong, Sichuan, PR China
| | - Rui Shen
- Department of Computer Science and Technology, School of China West Normal University, Nanchong, Sichuan, PR China
| | - Li Deng
- Department of Computer Science and Technology, School of China West Normal University, Nanchong, Sichuan, PR China
| | - Ya-Lan Tang
- Department of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, PR China.,North Sichuan Medical College, Nanchong, Sichuan, PR China
| | - Li-Hong Deng
- North Sichuan Medical College, Nanchong, Sichuan, PR China
| | - Mi Zhou
- Department of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, PR China
| | - Jun Li
- Department of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, PR China
| | - Bin Su
- Department of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, PR China
| | - Fan Xu
- Department of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, PR China
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Hong H, Fang X, Huang H, Wang Z, Lin T, Yao H. The derived neutrophil‐to‐lymphocyte ratio is an independent prognostic factor in patients with angioimmunoblastic T‐cell lymphoma. Br J Haematol 2020; 189:908-912. [PMID: 32103494 DOI: 10.1111/bjh.16447] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/08/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Huangming Hong
- Department of Oncology Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou China
| | - Xiaojie Fang
- Department of Medical Oncology Sun Yat‐sen University Cancer Center Guangzhou China
| | - He Huang
- Department of Medical Oncology Sun Yat‐sen University Cancer Center Guangzhou China
| | - Zhao Wang
- Department of Medical Oncology Sun Yat‐sen University Cancer Center Guangzhou China
| | - Tongyu Lin
- Department of Medical Oncology Sun Yat‐sen University Cancer Center Guangzhou China
| | - Herui Yao
- Department of Oncology Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Sun Yat‐Sen Memorial Hospital Sun Yat‐Sen University Guangzhou China
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Combining the Fibrinogen/Albumin Ratio and Systemic Inflammation Response Index Predicts Survival in Resectable Gastric Cancer. Gastroenterol Res Pract 2020; 2020:3207345. [PMID: 32184816 PMCID: PMC7060846 DOI: 10.1155/2020/3207345] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/28/2019] [Accepted: 01/18/2020] [Indexed: 02/07/2023] Open
Abstract
Aims Predicting the prognosis of gastric cancer using tumour-node-metastasis (TNM) staging is difficult as patients with the same TNM stage exhibit different prognoses. Methods This study investigated the prognostic value of the preoperative fibrinogen/albumin ratio (FAR)-systemic inflammation response index (SIRI) score in resectable gastric cancer (rGC). Results Clinicopathological features of 231 rGC patients were analysed retrospectively. Patients were divided into three groups: FAR-SIRI score 2 (FAR ≥ 0.071 and SIRI ≥ 0.84), 1 (FAR < 0.071 and SIRI ≥ 0.84), and 0 (SIRI < 0.84). Higher FAR-SIRI scores were associated with larger tumours, poorer differentiation, and advanced TNM stage (P < 0.05). Compared to those with FAR-SIRI scores of 0, patients with scores of 2 had poorer overall survival (OS). The FAR-SIRI score was an independent prognostic factor for OS in rGC. Conclusion The present data demonstrated that FAR-SIRI scores predicted radical gastric cancer surgical outcomes and may serve as a blood marker for identifying high-risk patients.
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Huang Z, Fu Z, Huang W, Huang K. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis. Am J Emerg Med 2019; 38:641-647. [PMID: 31785981 DOI: 10.1016/j.ajem.2019.10.023] [Citation(s) in RCA: 232] [Impact Index Per Article: 46.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/08/2019] [Accepted: 10/16/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) has been used to predict the prognosis of patients with sepsis with inconsistent results. This meta-analysis aimed to clarify the prognostic value of NLR in patients with sepsis. METHODS A comprehensive literature search for relevant studies, published prior to March 2019, was conducted using PubMed, Web of Science, and the China National Knowledge. Infrastructure database. Standard mean differences (SMDs) with 95% confidence intervals (CI) were used to evaluate the NLR of patients with sepsis retrospectively. Hazard ratios (HRs) with 95% CIs were used to evaluate the prognostic value of NLR in patients with sepsis. RESULTS Patients from 14 studies (n = 11,564) were selected for evaluation. Nine studies (1371 patients) analyzed the NLR in these patients. The pooled results showed significantly higher NLR in non-survivors than in survivors (random-effects model: SMD = 1.18, 95% CI; 0.42-1.94). Nine studies (10,685 patients) evaluated the prognostic value of NLR for sepsis; the pooled results showed that higher NLR was associated with poor prognosis in patients with sepsis (fixed-effects model: HR = 1.75, 95% CI; 1.56-1.97). Subgroup analysis revealed that study design, cut-off NLR, or primary outcome did not affect the prognostic value of NLR in patients with sepsis. CONCLUSION This meta-analysis indicates that NLR may be a helpful prognostic biomarker of patients with sepsis and that higher NLR values may indicate unfavorable prognoses in these patients.
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Affiliation(s)
- Zhiwei Huang
- Department of Intensive Care Unit, First People's Hospital of Qinzhou, Qinzhou 535001, China.
| | - Zhaoyin Fu
- Department of Intensive Care Unit, First People's Hospital of Qinzhou, Qinzhou 535001, China.
| | - Wujun Huang
- Department of Intensive Care Unit, First People's Hospital of Qinzhou, Qinzhou 535001, China
| | - Kegang Huang
- Department of Intensive Care Unit, First People's Hospital of Qinzhou, Qinzhou 535001, China.
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Mirili C, Paydas S, Kapukaya TK, Yılmaz A. Systemic immune-inflammation index predicting survival outcome in patients with classical Hodgkin lymphoma. Biomark Med 2019; 13:1565-1575. [PMID: 31631675 DOI: 10.2217/bmm-2019-0303] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: To evaluate the prognostic significance of neutrophil lymphocyte ratio, prognostic nutritional index, systemic immune-inflammation index (SII) and B2M in Hodgkin Lymphoma (HL). Materials & methods: Neutrophil-lymphocyte ratio, prognostic nutritional index, SII and B2M were analyzed to assess their prognostic value via the Kaplan-Meier method and Cox regression analysis in 122 HL patients, retrospectively. Results: SII was found to have the highest area under curve and the most sensitive and specific among all markers. In univariate analyses, all four parameters were prognostic for overall survival and progression-free survival, in multivariate analyzes only SII was found to be independent factors for both of them. Conclusion: SII can be suggested as a novel independent and better prognostic factor for predicting overall survival and progression-free survival in HL.
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Affiliation(s)
- Cem Mirili
- Department Of Medical Oncology, Faculty of Medicine, Ataturk University, Yakutiye, Erzurum, Turkey
| | - Semra Paydas
- Department Of Medical Oncology, Faculty of Medicine, Çukurova University, Sarıcam, Adana, Turkey
| | - Tuba Korkmaz Kapukaya
- Department Of Internal Medicine, Faculty of Medicine, Çukurova University, Sarıcam, Adana, Turkey
| | - Ali Yılmaz
- Department Of Medical Oncology, Faculty of Medicine, Ataturk University, Yakutiye, Erzurum, Turkey
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Zhang JB, Wang HH, Wang WB, Wang HY, Lu YM, Yu XF, Teng LS. Association of prealbumin/fibrinogen ratio with clinicopathologic characteristics of gastric cancer. Shijie Huaren Xiaohua Zazhi 2019; 27:1133-1141. [DOI: 10.11569/wcjd.v27.i18.1133] [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: 02/06/2023] Open
Abstract
BACKGROUND Previous studies have shown that prealbumin (PA) and fibrinogen (Fib) can be used to predict the clinicopathological features and prognosis of a variety of malignant tumors. Therefore, we speculated that the prealbumin-to-fibrinogen ratio (PA/F) can predict the clinicopathological features of patients with gastric cancer (GC) and tumor progression preoperatively.
AIM To explore the relationship between the PA/F ratio and clinicopathological features of patients with GC.
METHODS The preoperative clinical and pathological data of 210 patients with GC admitted to the First Affiliated Hospital of Zhejiang University from January 2017 to March 2019 were retrospectively analyzed. The patients were divided into either a low PA/F group or high PA/F group. The differences in clinical data and pathological features were compared between the two groups, and the correlation between PA/F values and other prognosis-related immunonutrient indicators was also analyzed.
RESULTS The PA/F ratio was significantly associated with age, tumor size, degree of differentiation, depth of invasion, lymph node metastasis, TNM stage, and neurovascular invasion (P < 0.05). The low PA/F value group showed greater age, larger tumor diameter, lower degree of differentiation, deeper infiltration, advanced TNM stage, and more frequent neurovascular invasion (P < 0.05). PA/F values were negatively correlated with multiple immune nutrition indicators, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-albumin ratio (CAR), and systemic immune-inflammation index (SII), but positively correlated with prognostic nutritional index (PNI).
CONCLUSION The PA/F ratio can be used as a predictor of preclinical clinicopathological features in patients with GC, and patients with a PA/F ratio ≤ 9.07 have a relatively poor prognosis. The PA/F value is associated with NLR, PLR, CAR, SII, and PNI.
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Affiliation(s)
- Jun-Bin Zhang
- Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Hao-Hao Wang
- Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Wei-Bin Wang
- Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Hai-Yong Wang
- Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Yi-Min Lu
- Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Xiong-Fei Yu
- Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Li-Song Teng
- Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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