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Liu M, Li X, Huang Y, Huang Z, Huang Q. Albumin to globulin ratio (AGR) in systemic lupus erythematosus: correlation with disease activity. J Int Med Res 2024; 52:3000605241244761. [PMID: 38661083 PMCID: PMC11047242 DOI: 10.1177/03000605241244761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/15/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE To investigate the role of albumin-to-globulin ratio (AGR) in systemic lupus erythematosus (SLE) and its relationship with disease activity. METHODS This retrospective study consecutively selected patients with SLE and healthy controls. Patients were divided into three groups according to the SLE Disease Activity Index 2000 (SLEDAI-2K): group 1 (mild disease activity, SLEDAI-2K ≤ 6), group 2 (moderate disease activity, SLEDAI-2K 7-12) and group 3 (severe disease activity, SLEDAI-2K > 12). Predictors of SLE disease activity were analysed by ordinal logistical regression. RESULTS A total of 101 Chinese patients with SLE and 75 healthy Chinese controls were included. Patients with SLE had lower AGR values than healthy individuals, and group 3 patients with SLE displayed lower AGR values than those in group 1, but similar values to group 2. AGR was inversely correlated with SLEDAI-2K (r = -0.543). Ordinal logistic regression analysis showed that lower AGR (β = -1.319) and lower complement C4 (β = -1.073) were independent risk factors for SLE disease activity. CONCLUSIONS AGR was decreased in patients with SLE and may be utilized as a useful inflammatory biomarker for monitoring SLE disease activity.
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Affiliation(s)
- Meng Liu
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xingjian Li
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yukai Huang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhengping Huang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Qidang Huang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, China
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2
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Roberts WS, Delladio W, Price S, Murawski A, Nguyen H. The efficacy of albumin-globulin ratio to predict prognosis in cancer patients. Int J Clin Oncol 2023; 28:1101-1111. [PMID: 37421476 DOI: 10.1007/s10147-023-02380-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
The goal of this systematic review was to identify all of the research within the last 10 years that investigated both the Albumin-Globulin Ratio (AGR) and outcomes of solid tumor cancer patients via quantitative prognostic variables. Multiple scientific databases were researched for journal articles that included keywords relating AGR to prognosis. Once isolated from the databases, the articles were de-duplicated and manually screened based on standardized inclusion/exclusion criteria in a blind format via Rayyan. The collective data were sorted by cancer type, corrected for population size, and used to calculate the average cut-off values for the most popular prognostic variables. In total, 18 independent types of cancer have been evaluated to see if AGR is a prognostic indicator based on multivariate analyses. The average cut-off value for AGR in overall survival was 1.356, while the average cut-off value for AGR in progression free survival was 1.292. AGR was found to be significantly associated with at least one prognostic variable in every type of cancer evaluated based on multivariate analyses. The ease of access and affordability of AGR makes it an invaluable tool applicable to nearly all patients. Overall, AGR is a proven prognostic variable that should always be considered in the evaluation of a solid tumor cancer patient's prognosis. Further research needs to be conducted studying the potential prognostic effect in more types of solid tumors.
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Affiliation(s)
- Will S Roberts
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA.
| | - William Delladio
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Shawn Price
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Alec Murawski
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Hoang Nguyen
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
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3
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Wu J, Wu A, Wang S, Zeng C, Wang R, Zhou J, Wang D. The value of lactate dehydrogenase to albumin ratio and immune inflammation biomarkers in colorectal cancer. Front Surg 2023; 10:1118403. [PMID: 36936656 PMCID: PMC10014997 DOI: 10.3389/fsurg.2023.1118403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/10/2023] [Indexed: 03/05/2023] Open
Abstract
Background Colorectal cancer (CRC) is one of the most prevalent gastrointestinal cancers. Evidence for the importance of inflammation and immunology in the development and progression of CRC is growing steadily. The purpose of this study was to determine the clinical importance of Lactic Dehydrogenase (LDH) to Albumin (ALB) Ratio (LAR) and immune-inflammation biomarkers (IIBs) in patients with CRC. Methods This study enrolled 382 CRC patients. The LAR was determined as the serum LDH(U/l) to ALB(g/l) ratio. We compared the levels of LAR and IIBs in different TNM stages and tumor differentiation. The relationship between LAR and IIBs and overall survival (OS) of CRC was determined by Cox regression models. A prognostic nomogram was created using the results of the multivariate analysis and the effectiveness of the nomogram was assessed using the ROC, calibration, and decision curves. We evaluated the relationship between LAR and IIBs and clinical features of CRC. Results The levels of LAR, SII, NLR and PLR in TNM IV stage group (LAR:5.92 (5.23-8.24); SII: 1040.02 (499.51-1683.54); NLR: 2.87 (2.07-5.3); PLR:187.08 (125.31-276.63)) were significantly higher than those in other groups. LAR and NLR showed no significant difference in different tumor differentiation groups, while SII and PLR in undifferentiated groups (SII:543.72 (372.63-1110.20); PLR: 147.06 (106.04-203.92)) were significantly higher than those in well and moderate groups (SII: 474.29 (323.75-716.01); PLR: 126.28 (104.31-167.88)). LAR (HR = 1.317, 95% CI = 1.019-1.454), TNM stage (HR = 2.895, 95% CI = 1.838-4.559), age (HR = 1.766, 95% CI = 1.069-2.922) and lymphocytes (HR = 0.663, 95% CI = 0.456-0.963) were predictors of OS. IIBs, including SII, NLR, and PLR are independent of OS. The LAR-based nomogram AUCs of 1-year, 3-year and 5-year survival probabilities in the training cohort were 0.86, 0.72, and 0.71, respectively, and the AUCs of the validation cohort were 0.85, 0.71, and 0.69 respectively. The LAR-based nomogram's ROC curves and calibration curves demonstrated higher OS discriminative performance. The decision curves demonstrated greater net benefit in the survival prediction. Conclusion Preoperative LAR is a potential prognostic marker in CRC patients, while SII, NLR, and PLR are independent of OS. LAR was associated with tumor stage in CRC patients, but not with tumor differentiation.
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Affiliation(s)
- Jiali Wu
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ao Wu
- School of Cyber Science and Engineering, Southeast University, Nanjing, China
| | - Songzi Wang
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chunxian Zeng
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Guangzhou, China
- Shenzhen Key Laboratory of Viral Oncology, Clinical Innovation & Research Center (CIRC), Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Ruizhi Wang
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Correspondence: Ruizhi Wang Dong Wang . cn
| | - Juan Zhou
- Department of Oncology, General Hospital of the Southern Theatre Command, PLA, Guangzhou, China
| | - Dong Wang
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Correspondence: Ruizhi Wang Dong Wang . cn
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4
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Chen L, Xu M, Huang Q, Liu Y, Ren W. Clinical significance of albumin to globulin ratio among patients with stroke-associated pneumonia. Front Nutr 2022; 9:970573. [PMID: 36051899 PMCID: PMC9424928 DOI: 10.3389/fnut.2022.970573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background It has been proven that the ratio of albumin to globulin (A/G) is a typical biomarker for monitoring inflammation and nutritional status. But the potential role of A/G in stroke-associated pneumonia (SAP) after acute ischemic stroke (AIS) remained unknown. Patients and methods Following inclusion criteria, 5,173 AIS patients were included and segmented into SAP (n = 897) and non-SAP (n = 4,276) groups. The differences in variables between groups were compared. The logistic regression model was used to determine the association between A/G and SAP, and a forest plot was drawn. Results Compared with the non-SAP group, the SAP group had a lower A/G level (P < 0.001). Then, A/G was divided into quartiles. In comparison to Q3 (A/G = 1.25–1.39), logistic regression revealed that patients with a lower A/G (A/G ≤ 1.09) had a higher risk of SAP (OR = 1.96, 95% CI, 1.56–2.46, P < 0.001). On the contrary, those with a higher A/G (A/G ≥ 1.4) had a lower SAP risk (OR = 0.73, 95% CI, 0.54–0.97, P = 0.029). Conclusion The study revealed that a low A/G level was associated with an increased SAP risk. Appropriate preventative measures for SAP should be taken in AIS patients with a low A/G level.
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Affiliation(s)
- Lingli Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Minjie Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Qiqi Huang
- Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuntao Liu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- *Correspondence: Yuntao Liu,
| | - Wenwei Ren
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenwei Ren,
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5
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Zhang R, Tao Z, Gong J, Ji Z, Yang M, Ma G, Li Y. Albumin to Globulin Ratio was associated with in-stent restenosis and revascularization events after percutaneous coronary intervention. Clin Transl Sci 2022; 15:1187-1195. [PMID: 35195938 PMCID: PMC9099125 DOI: 10.1111/cts.13236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 01/09/2023] Open
Abstract
In-stent restenosis is a common complication after percutaneous coronary intervention (PCI) for coronary heart disease requiring revascularization. We performed a retrospective analysis to assess the value of inflammatory biomarker Albumin to Globulin Ratio (AGR) in clinical prognosis of percutaneous coronary intervention (PCI). In total, 992 coronary heart disease (CHD) patients who underwent the first drug-eluting stent implantation and reexamination angiography in our hospital were enrolled in this study. Albumin to Globulin Ratio was measured. At mean follow-up of 11.2 ± 4 months, the in-stent restenosis (ISR) and revascularization events (including target lesion revascularization, target vessel revascularization, and revascularization of de novo lesions) occurred in 127 and 284 patients respectively. Compared with the non-ISR or non-event group, AGR was significantly lower in the ISR group and events group. Beyond that, albumin was significantly lower, while urea nitrogen, glucose and gensini score, as well as the proportions of a history of diabetes and peripheral vascular diseases, were significantly higher in the ISR group and events group. Age, heart rate, white blood cell, neutrophils, lymphocyte, monocyte and incidence of ischemic stroke were significantly higher in the events group. Multivariate cox regression analysis showed that AGR was independently associated with ISR (P = 0.032) and events (P = 0.024). Besides, Kaplan-Meier analysis indicated that the higher quartile of AGR had a lower rate of ISR (P = 0.038) and events (p ≤ 0.001). Finally, the receiver operating characteristic (ROC) curve for AGR in diagnosing ISR and events indicated that the area under the curve (AUC) were 0.56 and 0.57 respectively. Therefore, AGR is one of the most important factors that independently associate with the ISR and revascularization events after PCI.
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Affiliation(s)
- Rui Zhang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zaixiao Tao
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jing Gong
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhenjun Ji
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Mingming Yang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Genshan Ma
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yongjun Li
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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6
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Kim ES, Kwon Y, Choe YH, Kim MJ. Albumin-to-Globulin Ratio at 1 Year after Anti-Tumor Necrosis Factor α Therapy Can Serve as a Prognostic Biomarker in Pediatric Crohn's Disease Patients. Gut Liver 2021; 16:71-80. [PMID: 34092576 PMCID: PMC8761917 DOI: 10.5009/gnl20322] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/02/2021] [Accepted: 02/26/2021] [Indexed: 11/04/2022] Open
Abstract
Background/Aims The efficacy of biologics for the treatment of Crohn's disease (CD) is affected by the drug concentrations. We aimed to evaluate the importance of albumin and globulin which are known to be associated with drug concentrations as prognostic biomarkers in CD. Methods In total, 121 pediatric patients with CD who had received anti-tumor necrosis factor (TNF)-α therapy were retrospectively examined between January 2010 and February 2019. Results Relapse was observed in 48.8% of patients (59/121). The level of calprotectin (odds ratio, 2.13; p=0.03) and the albumin-to-globulin ratio (AGR) at 1 year after anti-TNF-α therapy (odds ratio, 0.0002; p=0.003) were associated with relapse. The AGR at 1 year after anti-TNF-α therapy was the only factor associated with the time-to-relapse (hazard ratio, 0.02; p<0.001). The optimal AGR cutoff value for the prediction of relapse was 1.47 (area under the curve, 0.916; p<0.001). The median infliximab trough level (TL) was lower in patients with AGRs <1.47 than in those with AGRs ≥1.47. Anti-drug antibody (ADA) concentrations were negatively correlated with the AGR at 1 year of anti-TNF-α therapy (r=-0.413, p=0.032). Conclusions AGR can be used to predict relapse. Patients with AGRs <1.47 at 1 year after anti-TNF-α therapy are more likely to have low drug TLs and develop ADAs, which increase the possibility of relapse than those with AGRs ≥1.47. Therefore, if the AGR at 1 year after anti-TNF-α therapy is less than 1.47, clinicians should monitor disease activity, assess the TLs of the anti-TNF-α agents, test for ADAs and determine the appropriate therapeutic strategies.
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Affiliation(s)
- Eun Sil Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yiyoung Kwon
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yon Ho Choe
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Jin Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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7
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Cai Y, Zhao Y, Dai Q, Xu M, Xu X, Xia W. Prognostic value of the albumin-globulin ratio and albumin-globulin score in patients with multiple myeloma. J Int Med Res 2021; 49:300060521997736. [PMID: 33682516 PMCID: PMC7944530 DOI: 10.1177/0300060521997736] [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] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The albumin-globulin ratio (AGR) has been identified as a promising prognostic predictor of mortality in patients with hematological malignancies. This study investigated the prognostic significance of AGR in patients with multiple myeloma. METHODS Two hundred patients diagnosed with multiple myeloma from January 2010 to October 2018 were retrospectively analyzed and followed up until December 2019. Kaplan-Meier curves and multivariate Cox regression analysis were applied to detect the prognostic value of AGR. RESULTS The median follow-up period was 36 months. The optimal cutoff of AGR was 1.16 according to receiver operating characteristic curve analysis. High AGR was significantly correlated with better overall survival (OS) and progression-free survival (PFS). Multivariate analysis revealed that low AGR was an independent prognostic factor for worse OS (hazard ratio [HR] = 1.82, 95% confidence interval [CI] = 1.15-2.94) and PFS (HR = 1.53, 95% CI = 1.09-2.17). CONCLUSIONS AGR may represent a potential prognostic biomarker in patients with multiple myeloma.Mini Abstract: We demonstrated that high AGR was associated with a favorable overall survival and progression-free survival in patients with multiple myeloma.
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Affiliation(s)
- Ying Cai
- Department of Hematology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu, China
| | - Yu Zhao
- Department of Hematology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu, China
| | - Qiuxin Dai
- Department of Hematology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu, China
| | - Maozhong Xu
- Department of Hematology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu, China
| | - Xin Xu
- Department of Hematology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu, China
| | - Wenkai Xia
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu, China.,Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany
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8
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Zeng H, Wang J, Deng R, Chen Z. Primary Diffuse Large B-Cell Lymphoma of the Female Urethra: A Case Report and Review of the Literature. Onco Targets Ther 2020; 13:13015-13022. [PMID: 33376350 PMCID: PMC7762437 DOI: 10.2147/ott.s283704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/17/2020] [Indexed: 11/23/2022] Open
Abstract
Primary urethral non-Hodgkin's lymphoma (NHL) is uncommon. This case study reports the case of a 52-year-old woman with a light red mass at the urethral orifice. Her clinical manifestations included frequent urination, urgency, dysuria, and occasionally blood in urine. The tumor was surgically removed, and the pathological and immunohistochemistry examination confirmed the presence of a diffuse large B-cell lymphoma (DLBCL). Examination using positron emission tomography/computed tomography (PET/CT) revealed multiple hypermetabolic lymph nodes next to the external iliac vessels and bilateral inguinal regions, and focal hypermetabolic lesions in the vulvar nodules (consistent with the changes caused by lymphoma infiltration). Eight cycles of chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and dexamethasone (R-CHOP) were prescribed after surgery. Re-examination using PET/CT showed lack of hypermetabolic tumor recurrence signs, and the presence of multiple slightly large lymph nodes in the lateral iliac vessels and inguinal regions, but without significant lymph node metabolism increases. To date, only fifteen cases of primary diffuse large B-cell lymphoma of the urethra (including this one) have been reported in the literature. Therefore, we reviewed the etiology, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of DLBCL based on the existing literature to help characterize this rare disease.
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Affiliation(s)
- Haiping Zeng
- The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou510405, People’s Republic of China
| | - Jun Wang
- Department of Urology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou510405, People’s Republic of China
| | - Runpei Deng
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou510405, People’s Republic of China
| | - Zhiqiang Chen
- Department of Surgery, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou510120, People’s Republic of China
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9
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Jelicic J, Larsen TS, Frederiksen H, Andjelic B, Maksimovic M, Bukumiric Z. Statistical Challenges in Development of Prognostic Models in Diffuse Large B-Cell Lymphoma: Comparison Between Existing Models - A Systematic Review. Clin Epidemiol 2020; 12:537-555. [PMID: 32581596 PMCID: PMC7266947 DOI: 10.2147/clep.s244294] [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] [Indexed: 01/21/2023] Open
Abstract
Background and Aim Based on advances in the diagnosis, classification, and management of diffuse large B-cell lymphoma (DLBCL), a number of new prognostic models have been proposed. The aim of this study was to review and compare different prognostic models of DLBCL based on the statistical methods used to evaluate the performance of each model, as well as to analyze the possible limitations of the methods. Methods and Results A literature search identified 46 articles that proposed 55 different prognostic models for DLBCL by combining different clinical, laboratory, and other parameters of prognostic significance. In addition, six studies used nomograms, which avoid risk categorization, to create prognostic models. Only a minority of studies assessed discrimination and/or calibration to compare existing models built upon different statistical methods in the process of development of a new prognostic model. All models based on nomograms reported the c-index as a measure of discrimination. There was no uniform evaluation of the performance in other prognostic models. We compared these models of DLBCL by calculating differences and ratios of 3-year overall survival probabilities between the high- and the low-risk groups. We found that the highest and lowest ratio between low- and high-risk groups was 6 and 1.31, respectively, while the difference between these groups was 18.9% and 100%, respectively. However, these studies had limited duration of follow-up and the number of patients ranged from 71 to 335. Conclusion There is no universal statistical instrument that could facilitate a comparison of prognostic models in DLBCL. However, when developing a prognostic model, it is recommended to report its discrimination and calibration in order to facilitate comparisons between different models. Furthermore, prognostic models based on nomograms are becoming more appealing owing to individualized disease-related risk estimations. However, they have not been validated yet in other study populations.
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Affiliation(s)
- Jelena Jelicic
- Department of Hematology, Odense University Hospital, Odense, Denmark
| | - Thomas Stauffer Larsen
- Department of Hematology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Henrik Frederiksen
- Department of Hematology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bosko Andjelic
- Department of Haematology, Blackpool Victoria Hospital, Lancashire Haematology Centre, Blackpool, UK
| | - Milos Maksimovic
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - Zoran Bukumiric
- Department of Statistics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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10
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Di QS, Xu T, Song Y, Zuo ZG, Cao FJ, Yu XJ, Tang JY, Zhang W, Li C, Wan GX, Cai XJ. High C-Reactive Protein to Albumin Ratio Predicts Inferior Clinical Outcomes in Extranodal Natural Killer T-Cell Lymphoma. Dose Response 2020; 18:1559325820917824. [PMID: 32284703 PMCID: PMC7139182 DOI: 10.1177/1559325820917824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/26/2020] [Accepted: 03/11/2020] [Indexed: 11/16/2022] Open
Abstract
Objective: The prognostic value of C-reactive protein to albumin ratio (CAR) has been
identified in several cancers but not in extranodal natural killer T-cell
lymphoma (ENKTL) as yet. We aimed to evaluate the prognostic value of CAR in
ENKTL. Methods: A retrospective study with 246 patients with ENKTL was performed to determine
the prognostic value of pretreatment CAR and examine the prognostic
performance of CAR incorporating with International Prognostic Index (IPI)
or natural killer/T-cell lymphoma prognostic index (NKPI) by nomogram. Results: The Cox regression analyses showed that high CAR (>0.3) independently
predicted unfavorable progression-free survival (PFS, P =
.011) and overall survival (OS, P = .012). In the
stratification analysis, the CAR was able to separate patients into
different prognoses regarding both OS and PFS in Ann Arbor stage I+II as
well as III+IV, IPI score 0 to 1, and NKPI score 1 to 2 subgroups (all
P < .05). Additionally, the predictive accuracy of
the IPI-based nomogram incorporating CAR, albumin to globulin ratio (AGR),
and IPI for OS and PFS appeared to be lower than the NKPI-based nomogram
incorporating CAR, age, AGR, extranodal site, and NKPI. Conclusion: Pretreatment CAR is a simple and easily accessible parameter for
independently predicting OS and PFS in patients with ENKTL.
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Affiliation(s)
- Quan-Shu Di
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Tao Xu
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Ying Song
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Zhi-Gang Zuo
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Feng-Jun Cao
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Xiong-Jie Yu
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Ji-Ying Tang
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Wei Zhang
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Chen Li
- Laboratory of Medicinal Plant, Institute of Basic Medical Sciences, School of Basic Medicine, Hubei University of Medicine, Shiyan, Hubei, China.,Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Biomedical Research Institute, Hubei University of Medicine, Shiyan, Hubei, China
| | - Guo-Xing Wan
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Xiao-Jun Cai
- Department of Oncology, Renmin Hospital, Hubei, China
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