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Jia G, Wang J, Wang H, Hu X, Long F, Yuan C, Liang C, Wang F. New insights into red blood cells in tumor precision diagnosis and treatment. NANOSCALE 2024; 16:11863-11878. [PMID: 38841898 DOI: 10.1039/d4nr01454e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Red blood cells (RBCs), which function as material transporters in organisms, are rich in materials that are exchanged with metabolically active tumor cells. Recent studies have demonstrated that tumor cells can regulate biological changes in RBCs, including influencing differentiation, maturation, and morphology. RBCs play an important role in tumor development and immune regulation. Notably, the novel scientific finding that RBCs absorb fragments of tumor-carrying DNA overturns the conventional wisdom that RBCs do not contain nucleic acids. RBC membranes are excellent biomimetic materials with significant advantages in terms of their biocompatibility, non-immunogenicity, non-specific adsorption resistance, and biodegradability. Therefore, RBCs provide a new research perspective for the development of tumor liquid biopsies, molecular imaging, drug delivery, and other tumor precision diagnosis and treatment technologies.
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Affiliation(s)
- Gaihua Jia
- Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
| | - Jun Wang
- Department of Laboratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China.
| | - Hu Wang
- Center for Single-Cell Omics and Tumor Liquid Biopsy, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
| | - Xin Hu
- Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
| | - Fei Long
- Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
| | - Chunhui Yuan
- Department of Laboratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China.
- Center for Single-Cell Omics and Tumor Liquid Biopsy, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
| | - Chen Liang
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
| | - Fubing Wang
- Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
- Center for Single-Cell Omics and Tumor Liquid Biopsy, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
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Li J, Xu Y, Tan SD, Wang Z. Impact of red blood cell distribution width (RDW) on postoperative outcomes in hepatocellular carcinoma (HCC) patients. Medicine (Baltimore) 2024; 103:e38475. [PMID: 38875439 PMCID: PMC11175885 DOI: 10.1097/md.0000000000038475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 06/16/2024] Open
Abstract
This study examines the relationship between red blood cell distribution width (RDW) and the prognosis of patients undergoing hepatectomy for hepatocellular carcinoma (HCC). Additionally, it explores the potential effect of RDW for the early identification of high-risk patients after surgery, advocating for timely interventions to improve outcomes. A comprehensive literature search was conducted on May 16, 2022, across PubMed (23 studies), Embase (45 studies), the Cochrane Library (1 study), and CNKI (17 studies), resulting in 6 relevant articles after screening. This analysis primarily focused on the postoperative outcomes of patients. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled to assess prognosis, with survival indicators including overall survival (OS) and disease-free survival (DFS). All 6 studies reported on OS, and 2 addressed DFS. A total of 1645 patients from 6 studies were included. The pooled analysis revealed that RDW is an independent prognostic factor for both OS (HR = 1.50, I² = 84%, 95% CI = 1.23-1.77, P < .01) and DFS (HR = 2.06, I² = 15%, 95% CI = 1.51-2.82, P < .01). Patients in the high RDW group exhibited significantly poorer OS and DFS compared to those in the low RDW group. RDW is a prognostic factor for HCC patients after surgery. Elevated RDW levels are associated with a poorer prognosis, adversely affecting both OS and DFS. RDW may serve as a valuable marker for stratifying risk and guiding intervention strategies in the postoperative management of HCC patients.
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Affiliation(s)
- Jin Li
- Department of Clinical Laboratory, Chongqing Hospital of Jiangsu Province Hospital, The People’s Hospital of Qijiang District, Chongqing, China
| | - Yi Xu
- Department of Hepatobiliary Surgery, Chongqing Hospital of Jiangsu Province Hospital, The People’s Hospital of Qijiang District, Chongqing, China
| | - Shu-De Tan
- Department of Radiology, Chongqing Hospital of Jiangsu Province Hospital, The People’s Hospital of Qijiang District, Chongqing, China
| | - Zhi Wang
- Department of Hepatobiliary Surgery, Chongqing Hospital of Jiangsu Province Hospital, The People’s Hospital of Qijiang District, Chongqing, China
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Wang Q, Zhang C, Qi C, Qiang Y, Zhang Z, Xu F, Shen Y. Esophageal surgical Apgar score (eSAS): A predictor for postoperative morbidity in patients undergoing neoadjuvant therapy and esophagectomy. Thorac Cancer 2024; 15:755-763. [PMID: 38390683 PMCID: PMC10995716 DOI: 10.1111/1759-7714.15246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The surgical Apgar score (SAS) quantifying three intraoperative indexes has been confirmed to be significantly associated with postoperative morbidity and prognosis in many surgical specialties. However, there are great limitations in its application for esophageal cancer (EC). This study aimed to assess the predictive capability of esophagectomy SAS (eSAS) in determining postoperative morbidity and overall survival (OS) in EC patients who had undergone neoadjuvant therapy. METHODS A retrospective evaluation was conducted on a cohort of 221 patients in which surgery- and tumor-related data were extracted and analyzed. Major morbidity was defined as complications meeting the criteria of Clavien-Dindo classification III or higher during hospitalization. Univariate and multivariate analyses were performed to identify potential risk factors for major morbidity. Kaplan-Meier analysis was utilized to calculate the OS and relapse-free survival (RFS). RESULTS The results exhibited that eSAS demonstrated potential predictive value for postoperative morbidity with an optimal cutoff value of 6. The eSAS and diabetes mellitus were two independent risk factors for the major morbidity; however, no correlation between the eSAS and the OS or RFS was detected. CONCLUSION The eSAS could be used as a predictor of major morbidity, while it was not correlated with OS and RFS.
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Affiliation(s)
- Qin Wang
- Department of Cardiothoracic Surgery, Jinling HospitalMedical School of Nanjing UniversityNanjingChina
| | - Chi Zhang
- Department of Cardiothoracic Surgery, Jinling HospitalMedical School of Nanjing UniversityNanjingChina
| | - Chen Qi
- Department of Cardiothoracic Surgery, Jinling HospitalMedical School of Nanjing UniversityNanjingChina
| | - Yong Qiang
- Department of Cardiothoracic Surgery, Jinling Hospital, School of MedicineSoutheast UniversityNanjingChina
| | - Zheng Zhang
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical MedicineNanjing Medical UniversityNanjingChina
| | - Fei Xu
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical MedicineNanjing Medical UniversityNanjingChina
| | - Yi Shen
- Department of Cardiothoracic Surgery, Jinling HospitalMedical School of Nanjing UniversityNanjingChina
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Lin S, Mao X, He W, Zhan Q. Association between red blood cell distribution width-to-platelet ratio and post-discharge readmission rate in patients with heart failure: A retrospective cohort study. Heliyon 2024; 10:e26549. [PMID: 38434056 PMCID: PMC10906436 DOI: 10.1016/j.heliyon.2024.e26549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Background To date, no studies have investigated the association between red blood cell distribution width (RDW)-to-platelet ratio (RPR) and readmission rates among patients with heart failure (HF). As such, the present study aimed to examine the relationship between RPR and readmission rates in patients with HF. Methods Data for this study were obtained from the Fourth People's Hospital (Zigong, Sichuan Province, China). Patients were diagnosed with HF in accordance with European Society of Cardiology criteria. The primary outcome was the 28-day readmission rate. Various logistic regression models were constructed to explore the association between RPR and the 28-day readmission rate. Results The study comprised 1978 patients with HF, with a 28-day readmission rate of 6.98%. RPR emerged as an independent risk factor for 28-day readmission, evidenced by consistent results across the various regression-adjusted models. The covariate-adjusted propensity score model demonstrated that every 0.1 increase in RPR was associated with an 8.2% increase in 28-day readmission rate (odds ratio [OR] 1.082 [95% confidence interval (CI) 1.012-1.158]; P = 0.0212). Similarly, each 0.1 change in RPR was associated with a 9.8% (OR 1.098 [95% CI 1.014-1.188]) and 7.3% (OR 1.073 [95% CI 0.991-1.161]) increase in 3- and 6-month readmission rates, respectively. However, RPR was not statistically associated with the 6-month readmission rate. Curve fit plots illustrated a nonlinear positive correlation between RPR and 28-day, and 3- and 6-month readmissions. Moreover, the effects of RPR on 28-day, and 3- and 6-month readmission rates remained robust across subgroup variables in stratified analysis. Finally, the effect sizes of pooled multiply imputed data were consistent with the original data, suggesting robust results. Conclusion RPR was an independent risk factor for 28-day readmission among patients with HF and also demonstrated modest predictive value for readmissions at 3 and 6 months, despite being non-significant for the 6-month readmission rate. Early identification of patients with HF with elevated RPR would facilitate management and may confer favorable effects on prognosis.
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Affiliation(s)
- Shan Lin
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xueyan Mao
- Department of Medical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Wanmei He
- Department of Medical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Qingyuan Zhan
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
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Rahchamani M, Sedghi M, Hakimi A, Nejatianfar M, Javaheri T, Tavakoli R, Ahmadi R, Makarem M, Azmi‐Naei N, Zahmatkesh Sangani S, Kamandi N, Soleimanian A, Shavaleh R, Foogerdi M, Rahmani K. Prognostic value of red blood cell distribution width and D-Dimer in diffuse large B-cell lymphoma: Systematic review and meta-analysis. Cancer Rep (Hoboken) 2024; 7:e1936. [PMID: 37997648 PMCID: PMC10809198 DOI: 10.1002/cnr2.1936] [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: 07/19/2023] [Revised: 09/29/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The significant role of red blood cell distribution width (RDW) and D-Dimer as prognostic factors in patients with some blood malignancies has been reported recently. AIM We designed and performed a meta-analysis to investigate the prognostic roles of RDW and D-Dimer in subjects with diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS We systematically reviewed PubMed-Medline, SCOPUS, EMBASE, Web of Science Core Collection, and Google Scholar up to the present to look for publications on prognostic effects of RDW and D-Dimer in DLBCL patients. For investigation of the associations between RDW and D-Dimer with the overall survival (OS) and progression-free survival (PFS) of the DLBCL cases, hazard ratio (HR) with 95% confidence intervals (CIs) was used. RESULTS We included 13 eligible studies in the present meta-analysis. The results of pooled analysis showed that increased levels of RDW was related to poor OS (HR = 2.01, 95% CI: 1.62-2.48, p value <.01, I2 = 0%) and poor PFS (HR = 1.52, 95% CI: 1.24-1.85, p value <.01, I2 = 16%) among the DLBCL patients. Similarly, a significant relationship was found between increased D-Dimer and poor OS (HR = 2.30, 95% CI: 1.03-5.14, p value <.05, I2 = 95%) of the DLBCL patients as well. In addition, there was no significant heterogeneity in OS (p value H = 0.65) and PFS (p value H = 0.31) related to RDW among studies included in the meta-analysis. CONCLUSION Our finding clearly confirmed that elevated RDW levels and D-Dimer were associated with adverse OS and PFS in DLBCL.
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Affiliation(s)
- Maryam Rahchamani
- Department of Internal Medicine, Faculty of MedicineTehran University of Medical SciencesTehranIran
| | - Mohammad Sedghi
- Molecular and Cellular Biology, Department of Biology, Yadegar‐e‐Imam Khomeini (RAH) Shahr‐e‐Ray BranchIslamic Azad UniversityTehranIran
| | - Ali Hakimi
- Department of Clinical BiochemistryMashhad University of Medical SciencesMashhadIran
| | - Mahdi Nejatianfar
- Department of Research and DevelopmentOrganic Chemistry Hila Pharmaceutical CoMashhadIran
| | - Tohid Javaheri
- Department of Genetics, Young Research and Elites ClubIslamic Azad University, Mashhad BranchMashhadIran
| | - Reza Tavakoli
- Department of RadiologyArak University of Medical SciencesArakIran
| | - Ramtin Ahmadi
- Cellular and MolecularIslamic Azad University of MashhadMashhadIran
| | - Mansoureh Makarem
- Health Vice‐ChancellorTorbat‐e Jam Faculty of Medical SciencesTorbat‐e JamIran
| | - Nazanin Azmi‐Naei
- Department of Epidemiology, School of Public HealthShahroud University of Medical SciencesShahroudIran
| | | | - Neda Kamandi
- Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | - Rasoul Shavaleh
- Department of Epidemiology, School of Public HealthIran University of Medical SciencesTehranIran
| | - Molood Foogerdi
- Department of Emergency Medicine, Faculty of MedicineBirgand University of Medical SciencesBirjandIran
| | - Kazem Rahmani
- Department of Epidemiology, School of Public HealthIran University of Medical SciencesTehranIran
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Yang Y, Liu Z, Jiang C, Pan J, Yu B, Zhu K, Xu Y, Li Z. Prognostic Value of Combination of Lymphocyte-to-Monocyte-Ratio and CYFRA 21-1 in Esophageal Squamous Cell Carcinoma. World J Surg 2023; 47:3240-3249. [PMID: 37792039 DOI: 10.1007/s00268-023-07190-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND This study aimed to investigate the potential of a combined score based on CYFRA 21-1 level and LMR as a prognostic predictor for patients with ESCC. METHODS A total of 460 patients who underwent esophagectomy were analyzed, and three groups were established based on the CA-LMR score. OS and RFS were evaluated using the Kaplan-Meier analysis, and associated factors were analyzed by univariate and multivariate Cox analysis. A mpStage system was also established based on the CA-LMR score. RESULTS The allocation of CA-LMR score of 0, 1, and 2 was 107 (23.3%), 280 (60.9%), and 73 (15.9%). There was a significant association between CA-LMR and male gender (P = 0.001), lower BMI (P = 0.035), longer tumor lesions (P = 0.002), and high pT, pN, pStage (P < 0.001, P = 0.011, P = 0.001). The 5-year OS rates for CA-LMR scores of 0, 1, and 2 were 75.4%, 60.2%, and 32.8%, respectively (P < 0.001). Multivariate analysis showed that CA-LMR score (P = 0.011) was an independent prognostic factor for OS. The proposed mpStage system, based on CA-LMR score, demonstrated superior discriminatory ability, monotonicity, homogeneity, and prognosis prediction ability over AJCC 8th pStage system. CONCLUSIONS The CA-LMR score, combined with tumor marker and inflammatory index, could use as a potential prognostic indicator; moreover, our modified pStage system exhibited superior stratification and prognostic accuracy for patients with ESCC.
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Affiliation(s)
- Yuxin Yang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China
| | - Zhichao Liu
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China
| | - Chao Jiang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China
| | - Jie Pan
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China
| | - Boyao Yu
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China
| | - Kaiyuan Zhu
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China
| | - Yunhua Xu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China.
| | - Zhigang Li
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China.
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No.241 Huaihai West Rd, Shanghai, 200030, China.
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Du JQ, Zhang F, Wang CQ, Zhu JF, Xu LX, Yang YH, Han MF, Hu Y. Effects of peripheral blood neutrophil/lymphocyte ratio levels and their changes on the prognosis of patients with early cervical cancer. Front Oncol 2023; 13:1139809. [PMID: 37829340 PMCID: PMC10565220 DOI: 10.3389/fonc.2023.1139809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
Although some studies have reported on the levels and clinical significance of peripheral blood neutrophil/lymphocyte ratio (NLR) in cervical cancer, the role of NLR levels and their changes preoperatively and postoperatively in early cervical cancer remain unclear. Our analyses explored the preoperative and postoperative NLR in 203 patients with stage I-IIA cervical cancer and evaluated the relationship between NLR changes, clinicopathological characteristics, and patient prognosis. The cut-off preoperative and postoperative NLR values were determined using receiver operating characteristic curve analysis. Preoperative NLR correlated with age, menopausal status, tumor size, and vascular infiltration, whereas postoperative NLR correlated with tumor differentiation. Patients with cervical cancer with a high preoperative NLR had significantly shorter overall survival (OS) and progression-free survival (PFS) than other patients, whereas PFS was significantly lower in the high postoperative NLR group. When comparing postoperative and preoperative NLR values, we observed a significantly higher rate of increase in postmenopausal patients and those without vascular infiltration than that among premenopausal patients and those with vascular infiltration. However, no clear difference in prognosis was observed between the groups with increased and decreased NLR. Therefore, a high peripheral blood NLR may predict a poor prognosis in patients with early cervical cancer. The effect of NLR changes on the prognosis of patients with cervical cancer requires further verification in multicenter studies.
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Affiliation(s)
- Jun-Qiang Du
- Department of Gynecology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - Fan Zhang
- Department of Gynecology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - Chao-Qun Wang
- Department of Pathology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - Ju-Fan Zhu
- Department of Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Li-Xia Xu
- Department of Gynecology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - Yi-Heng Yang
- Department of Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meng-Fei Han
- Department of Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yan Hu
- Department of Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Santos-Silva MA, Sousa N, Majar M, Machado M, Reis J, Sousa JC. Pattern recognition of hematological profiles of tumors of the digestive tract: an exploratory study. Front Med (Lausanne) 2023; 10:1208022. [PMID: 37663664 PMCID: PMC10469010 DOI: 10.3389/fmed.2023.1208022] [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: 04/18/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Aims In this study, we aimed to apply laboratory blood analysis to identify the hematological (based on hemoglobin concentration, erythrocytes, hematocrit, and RDW count) profiles associated with the most prevalent forms of digestive tract malignancies. Furthermore, we aimed to evaluate how these profiles contributed to distinguishing these tumors at diagnosis. Methods We collected data from the date of ICD-10 diagnostic coding for C15 esophagus, C16 stomach, C18 colon, and C19 rectum tumors of 184 individuals. The statistical analysis and data visualization approaches, notably the heat map and principal component analysis (PCA), allowed for creating a summary hematological profile and identifying the most associated parameters for each pathologic state. Univariate and multivariate data modeling and ROC analysis were performed in both SPSS and Python. Results Our data reveal unique patterns based on tumor development anatomical location, clustering the C18 colon and C19 rectum from the C15 esophagus and C16 stomach. We found a significant difference between C16 stomach carcinoma and the other tumors, which substantially correlated with raised RDW in conjunction with low hemoglobin concentration, erythrocytes, and hematocrit counts. In contrast, C18 colon carcinoma had the higher red blood cell count, allowing for the best classification metrics in the test set of the binary logistic regression (LR) model, accounting for an AUC of 0.77 with 94% sensitivity and 52% specificity. Conclusion This study emphasizes the significance of adding hematological patterns in diagnosing these malignancies, which could path further investigations regarding profiling and monitoring at the point of care.
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Affiliation(s)
- Miguel A. Santos-Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga (2CA), Braga, Portugal
- Association P5 Digital Medical Center (ACMP5), Braga, Portugal
| | - Marina Majar
- Clinical Pathology Department, Hospital de Braga, Braga, Portugal
| | - Miguel Machado
- Clinical Pathology Department, Hospital de Braga, Braga, Portugal
| | - Joana Reis
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Joao C. Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Lu Y, Kwong K, Wells J, Edwards A, Chen Z, Tseng TS, Zhang K. Quitting smoking after a cancer diagnosis is associated with high-risk neutrophil-to-lymphocyte ratio among tobacco use-related cancer survivors. Sci Rep 2023; 13:2745. [PMID: 36797297 PMCID: PMC9935916 DOI: 10.1038/s41598-023-27624-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 01/04/2023] [Indexed: 02/18/2023] Open
Abstract
Quitting smoking could potentially minimize the risk of a high neutrophil-to-lymphocyte ratio (NLR) among tobacco use-related (TUR) cancer survivors. A total of 1263 TUR cancer survivors aged 20 to 85 years old were investigated using data from the National Health and Nutritional Examination Survey 1999-2018. The primary outcome was the NLR, which was defined as having two levels: high-risk (≥ 3) and low-risk (< 3). The association between smoking cessation time and a high-risk NLR level was analyzed using weighted logistic regression models. Overall, the current smoking rate of TUR cancer survivors was found to be 21.7%. Older age (75 years above), gender and respiratory-related cancers are covariables associated with high risk of NLR levels for individual who identified as Non-Hispanic White (NHW). Non-Hispanic Black (NHB) (n = 27) who quit smoking after a cancer diagnosis were associated with the highest risk of a high NLR (OR 4.83, 95% CI 1.40-16.61, p = 0.01) compared to NHB nonsmokers (n = 139). These findings suggest that the risk of a high NLR level is strongly associated with the time of smoking cessation in NHB TUR cancer survivors. As a result, NHB TUR cancer survivors should quit smoking as soon as possible because the benefits of quitting smoking were observed over the 5 year period following smoking cessation.
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Affiliation(s)
- You Lu
- Department of Physics and Computer Science, Xavier University of Louisiana, New Orleans, LA, USA
| | - Katherine Kwong
- Department of Human Development, Connecticut College, New London, CT, USA
| | - James Wells
- Department of Physiology, Tulane University, New Orleans, LA, USA
| | - Andrea Edwards
- Department of Physics and Computer Science, Xavier University of Louisiana, New Orleans, LA, USA
| | - Zhong Chen
- Department of Physics and Computer Science, Xavier University of Louisiana, New Orleans, LA, USA
| | - Tung-Sung Tseng
- Behavioral and Community Health Science, School of Public Health, Louisiana State University Health Science Center, 2020 Gravier Street, Room 213, New Orleans, LA, 70112, USA.
| | - Kun Zhang
- Department of Physics and Computer Science, Xavier University of Louisiana, New Orleans, LA, USA.
- Bioniformatics Core of Xavier NIH RCMI Center of Cancer Research, Xavier University of Louisiana, 1 Drexel Drive, 540 NCF Annex, New Orleans, LA, 70125, USA.
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Muacevic A, Adler JR, Bahadır Altun H, Tulgar S, Ültan Özgen G. Can Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, or Systemic Immune Inflammation Index Be an Indicator of Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy? Cureus 2023; 15:e33955. [PMID: 36820108 PMCID: PMC9938425 DOI: 10.7759/cureus.33955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/20/2023] Open
Abstract
AIM Through this study, we aim to investigate whether biomarkers like the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) might predict the postoperative first 24 hours analgesic requirement and pain scores of patients undergoing laparoscopic cholecystectomy. Material & Method: After receiving the local ethical board approval, records of 67 patients, aged between 18 and 75 years, with ASA classifications I-III who underwent elective laparoscopic cholecystectomy were retrospectively evaluated to record postoperative analgesic requirements and numerical pain scale (NRS) scores. NLR, PLR, and SII scores were calculated from preoperative hemograms and compared with analgesic requirements and NRS scores. RESULTS The data of 67 patients were evaluated. There was no correlation between postoperative tramadol use and NRS scores, PLR, or SII values (p>0.05). NRS scores and the cumulative 24-hour postoperative tramadol use were correlated (p=0.0001), as it was observed that patients with high NRS scores used higher amounts of tramadol. Additionally, a poor statistically significant correlation was found between PDW (Platelet distribution width) value and tramadol dose (AUC = 0.611). CONCLUSION No significant association between NLR, PLR, SII, pain scores, and tramadol use was detected.
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Peng MY, Zuo ZG, Cao FJ, Yu YD, Cai XJ, Wan GX. Elevated Preoperative NMPR Predicts an Unfavorable Chance of Survival in Resectable Esophageal Squamous Cell Carcinoma. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121808. [PMID: 36557010 PMCID: PMC9788475 DOI: 10.3390/medicina58121808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
Background and objectives: Combined peripheral neutrophil−platelet indexes reflecting the systemic inflammatory status have been reported to predict the clinical outcome in patients with various types of cancer. However, the prognostic value of combined neutrophil−platelet indexes in operable esophageal squamous cell carcinoma (ESCC) remains unclear. The study introduced a novel combined neutrophil−meanplateletvolume−platelet ratio (NMPR) index and investigated its clinical and prognostic value in patients with operable ESCC receiving curative surgery. Materials and Methods: A retrospective analysis of the clinicopathologic data of 277 consecutive ESCC patients who received curative resection at Zhejiang Cancer Hospital in China between January 2007 and December 2010 was conducted (the training cohort). In addition, the clinicopathologic data of 101 resectable ESCC patients at Renmin Hospital of Hubei University of Medicine between December 2018 and June 2021 were collected (the external validation cohort). The optimal cutoff value of NMPR concerning overall survival (OS) in the training cohort was determined by X-tile software. Univariate and multivariate Cox regression analyses were used to evaluate the prognostic value of NMPR along with other variables in the training cohort, which was further validated with the same cutoff value in the external validation cohort. Significant predictors of OS were used to construct the nomogram, of which the discrimination and calibration was evaluated by concordance index (C-index) and calibration plots. Results: With a cutoff value of 16.62, the results from both the training and external validation cohorts supported the association of high NMPR (>16.62) with increased tumor length and advanced T stage but not with other variables. In the training cohort, a significant association between shorter OS and high NMPR (p = 0.04) as well as high CRP (p < 0.001), poor tumor differentiation (p = 0.008), advanced T stage (p = 0.006), advanced N stage (p < 0.001) and high CEA (p = 0.007) was revealed. Additionally, the high NMPR was verified to independently predict unfavorable OS (p = 0.049) in the external validation cohort. The C-index of the OS nomogram cooperating significant predictors in the training cohort was 0.71 and the calibration plots of the OS nomogram fitted well. Conclusions: The present study demonstrates that high NMPR is an independent predictor of unfavorable OS in resectable ESCC patients without neoadjuvant therapy.
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Affiliation(s)
- Meng-Ying Peng
- Graduate Student Training Base, Graduate School of Jinzhou Medical University, Jinzhou 121004, China
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Zhi-Gang Zuo
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Feng-Jun Cao
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Yuan-Dong Yu
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Xiao-Jun Cai
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
- Correspondence: (X.-J.C.); (G.-X.W.)
| | - Guo-Xing Wan
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
- Institute of Cancer, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
- Correspondence: (X.-J.C.); (G.-X.W.)
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Zhang W, Wang W, Wu J, Tian J, Yan W, Yuan Y, Yao Y, Shang A, Quan W. Immune cell-lipoprotein imbalance as a marker for early diagnosis of non-small cell lung cancer metastasis. Front Oncol 2022; 12:942964. [PMID: 36353553 PMCID: PMC9638068 DOI: 10.3389/fonc.2022.942964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 10/06/2022] [Indexed: 01/28/2023] Open
Abstract
The underlying molecular mechanisms and evolutionary patterns of lung cancer metastasis remain unclear, resulting in a lack of effective indicators for early diagnosis of metastasis. We retrospectively analyzed 117 patients with primary non-small cell lung cancer (NSCLC) admitted to Tongji Hospital of Tongji University in 2021, of which 93 patients with tumor metastasis were set as the metastasis group. 24 patients without metastasis were set as the non-metastasis group. The differences of each index in the two groups of patients and the expression levels in different TNM stages were compared. This study intends to evaluate the diagnostic value and net clinical benefit of common blood-related indicators Neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR), High density lipoprotein/neutrophil (HNR), High density lipoprotein/monocyte (HMR) and combined assays in NSCLC metastasis for the early diagnosis of patients with NSCLC metastasis. It was found that the level of NLR was higher in metastatic NSCLC than non-metastatic, but the level of LMR, HNR and HMR was lower. The levels of NLR, LMR, HNR and HMR in patients with different TNM stages showed that NLR levels increased with TNM stage, while LMR, HNR and HMR levels decreased. The threshold probability range of the 4 combined tests was greater and the overall clinical benefit rate was higher compared to the individual tests. Our findings suggest that NLR, LMR, HNR and HMR have better diagnostic value for NSCLC metastasis. This study provides a clinical basis for investigating the mechanisms by which immune cells and lipid metabolism-related proteins remodel the microenvironment prior to NSCLC metastasis.
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Affiliation(s)
- Wei Zhang
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weiwei Wang
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China,Department of Pathology, Tinghu People’s Hospital, Yancheng, China
| | - Junlu Wu
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiale Tian
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wenhui Yan
- Department of Laboratory Medicine, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji Univeirsity School of Medicine, Shanghai, China
| | - Yi Yuan
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yiwen Yao
- Department of Internal Medicine V-Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
| | - Anquan Shang
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China,*Correspondence: Anquan Shang, ; Wenqiang Quan,
| | - Wenqiang Quan
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China,*Correspondence: Anquan Shang, ; Wenqiang Quan,
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Chen W, Li D, Bian X, Wu Y, Xu M, Wu M, Tao M. Peripheral Blood Markers Predictive of Progression-Free Survival in Advanced Esophageal Squamous Cell Carcinoma Patients Treated With PD-1 Inhibitors Plus Chemotherapy as First-Line Therapy. Nutr Cancer 2022; 75:207-218. [PMID: 36190755 DOI: 10.1080/01635581.2022.2123533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Aim: To determine the prognostic value of peripheral blood markers in advanced esophageal squamous cell carcinoma (ESCC) patients receiving programmed cell death protein 1 inhibitors plus chemotherapy as first-line therapy. Methods: A retrospective analysis of 54 patients with advanced ESCC was performed to assess 12 blood markers involving inflammation, nutrition, and tumor burden. Analysis of variance or Kruskal-Wallis tests were used to explore the difference in markers among different response to therapy. Survival curves were constructed using the Kaplan-Meier method. Multivariate Cox models were applied to identify independent predictors of outcome. Results: Patients who achieved response had significantly higher prealbumin, increased BMI, and lower hs-CRP levels at baseline compared with those who experienced disease progression. In the univariate analysis, ALI > 23.55, PNI > 45.175, NLR ≤ 5, and hs-CRP ≤ 6.7 mg/L were significantly associated with a better progression-free survival. Cox regression analysis revealed that ALI >23.55 (P = 0.037) and hs-CRP ≤6.7 mg/L (P = 0.043) were independently associated with superior PFS. Increased tumor abnormal protein (TAP) levels post two cycles was significantly associated with a worse prognosis (P = 0.004). Conclusions: A baseline signature of low ALI and high hs-CRP as well as an early increase in TAP in ESCC appear to be predictive of inferior PFS.
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Affiliation(s)
- Wei Chen
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Dapeng Li
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuyu Bian
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan Wu
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mengdan Xu
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mengyao Wu
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Min Tao
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Oncology, DuShu Lake Hospital Affiliated to Soochow University, Suzhou, China
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14
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Zhao Y, Hong X, Xie X, Guo D, Chen B, Fu W, Wang L. Preoperative systemic inflammatory response index predicts long-term outcomes in type B aortic dissection after endovascular repair. Front Immunol 2022; 13:992463. [PMID: 36248781 PMCID: PMC9554789 DOI: 10.3389/fimmu.2022.992463] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives Inflammation is a hallmark of the initial development and progression of aortic dissection. This study aimed to investigate the value of preoperative inflammatory biomarkers in predicting aorta-related adverse events (AAEs) after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection. Methods We included all patients who underwent TEVAR for type B aortic dissection between November 2016 and November 2020 in this single-center, retrospective cohort study. Patients were divided into two groups: the AAEs group (n = 75) and the non-AAEs group (n = 126). Preoperative inflammatory biomarkers were recorded, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammatory response index (SIRI). Patients were followed-up for the development of AAEs. Prediction accuracy of inflammatory biomarkers for AAEs were evaluated using the area under the receiver operating characteristic curves. Results This study included 201 patients, of whom 80.0% were men, with a mean age of 59.1 ± 12.5 years. A total of 75 patients developed AAEs after TEVAR. The AUCs of NLR, MLR, PLR, SII, and SIRI for AAEs were.746,.782,.534,.625 and.807, respectively. Age and SIRI were independent risk factors for the AAEs after TEVAR (HR 3.264, p <.001; HR 4.281, p <.001, respectively). Survival analysis revealed significantly lower AAE-free status in patients with preoperative SIRI > = 4 (p <.001). Conclusion Increased preoperative SIRI and age are independent risk factors for AAEs after TEVAR in type B aortic dissection.
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Affiliation(s)
- Yufei Zhao
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Xiang Hong
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Xinsheng Xie
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Daqiao Guo
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Bin Chen
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Weiguo Fu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
- *Correspondence: Lixin Wang, ; Weiguo Fu,
| | - Lixin Wang
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
- *Correspondence: Lixin Wang, ; Weiguo Fu,
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15
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Guo YY, Li ZJ, Du C, Gong J, Liao P, Zhang JX, Shao C. Machine learning for identifying benign and malignant of thyroid tumors: A retrospective study of 2,423 patients. Front Public Health 2022; 10:960740. [PMID: 36187616 PMCID: PMC9515945 DOI: 10.3389/fpubh.2022.960740] [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: 06/03/2022] [Accepted: 08/23/2022] [Indexed: 01/24/2023] Open
Abstract
Thyroid tumors, one of the common tumors in the endocrine system, while the discrimination between benign and malignant thyroid tumors remains insufficient. The aim of this study is to construct a diagnostic model of benign and malignant thyroid tumors, in order to provide an emerging auxiliary diagnostic method for patients with thyroid tumors. The patients were selected from the Chongqing General Hospital (Chongqing, China) from July 2020 to September 2021. And peripheral blood, BRAFV600E gene, and demographic indicators were selected, including sex, age, BRAFV600E gene, lymphocyte count (Lymph#), neutrophil count (Neu#), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), red blood cell distribution width (RDW), platelets count (PLT), red blood cell distribution width-coefficient of variation (RDW-CV), alkaline phosphatase (ALP), and parathyroid hormone (PTH). First, feature selection was executed by univariate analysis combined with least absolute shrinkage and selection operator (LASSO) analysis. Afterward, we used machine learning algorithms to establish three types of models. The first model contains all predictors, the second model contains indicators after feature selection, and the third model contains patient peripheral blood indicators. The four machine learning algorithms include extreme gradient boosting (XGBoost), random forest (RF), light gradient boosting machine (LightGBM), and adaptive boosting (AdaBoost) which were used to build predictive models. A grid search algorithm was used to find the optimal parameters of the machine learning algorithms. A series of indicators, such as the area under the curve (AUC), were intended to determine the model performance. A total of 2,042 patients met the criteria and were enrolled in this study, and 12 variables were included. Sex, age, Lymph#, PLR, RDW, and BRAFV600E were identified as statistically significant indicators by univariate and LASSO analysis. Among the model we constructed, RF, XGBoost, LightGBM and AdaBoost with the AUC of 0.874 (95% CI, 0.841-0.906), 0.868 (95% CI, 0.834-0.901), 0.861 (95% CI, 0.826-0.895), and 0.837 (95% CI, 0.802-0.873) in the first model. With the AUC of 0.853 (95% CI, 0.818-0.888), 0.853 (95% CI, 0.818-0.889), 0.837 (95% CI, 0.800-0.873), and 0.832 (95% CI, 0.797-0.867) in the second model. With the AUC of 0.698 (95% CI, 0.651-0.745), 0.688 (95% CI, 0.639-0.736), 0.693 (95% CI, 0.645-0.741), and 0.666 (95% CI, 0.618-0.714) in the third model. Compared with the existing models, our study proposes a model incorporating novel biomarkers which could be a powerful and promising tool for predicting benign and malignant thyroid tumors.
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Affiliation(s)
- Yuan-yuan Guo
- Department of Laboratory Medicine, Chongqing General Hospital, Chongqing, China
| | - Zhi-jie Li
- Department of Laboratory Medicine, Chongqing General Hospital, Chongqing, China
| | - Chao Du
- Department of Laboratory Medicine, Fuling Center Hospital of Chongqing City, Chongqing, China
| | - Jun Gong
- Department of Information Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Pu Liao
- Department of Laboratory Medicine, Chongqing General Hospital, Chongqing, China,*Correspondence: Pu Liao
| | - Jia-xing Zhang
- Department of Laboratory Medicine, Chongqing General Hospital, Chongqing, China
| | - Cong Shao
- Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China
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Hu H, Zhang J, Yan H, Qin C, Guo H, Liu T, Tang S, Zhou H. Development and validation of a novel prognostic model for patients with surgically resected esophageal squamous cell carcinoma. Front Oncol 2022; 12:955353. [PMID: 36059713 PMCID: PMC9435602 DOI: 10.3389/fonc.2022.955353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/18/2022] [Indexed: 01/17/2023] Open
Abstract
Background and objectives Esophageal squamous cell carcinoma (ESCC) is the most common pathological type of esophageal malignancy in most regions of the world. The study aimed to identify risk factors and develop a predictive model for ESCC following surgical resection. Patients and methods A total of 533 ESCC patients who underwent surgical resection from Suining Central Hospital were enrolled in the study. Cox proportional hazards regression and Least Absolute Shrinkage and Selection Operator (LASSO) regression were performed to identify significant prognostic factors. A prognostic model was constructed, and the receiver operating characteristic (ROC) curve, concordance index (C-index), and decision cure analysis (DCA) were used to evaluate the discrimination and calibration of the prognostic model. Subsequently, we built a nomogram for overall survival (OS) incorporating the prognostic factors, and a calibration plot was employed to assess the consistency between the predicted survival and the observed survival. Based on the model risk score, we split the patients into two subgroups, low-risk and high-risk, and we analyzed the survival time of these two groups using Kaplan–Meier (K-M) survival plots. Results Five independent prognosis factors were identified as independent risk factors for OS in ESCC patients who underwent surgical resection. The C-index, ROC curve, and DCA showed that the prognostic model had good predictive accuracy and discriminatory power in the training cohort and validation cohort than other clinical features. A nomogram consisting of prognosis factors showed some superior net benefit. K-M survival plots showed significant differences in OS between the low-risk and high-risk groups. Similar results were observed in the subgroup analysis based on age, grade, and stage. Univariate and multivariate Cox regression analyses revealed that both risk score and risk group are independent prognostic factors in the patient cohort. Conclusions This study put forward a novel prognostic model based on clinical features; biopsy data and blood biomarkers may represent a promising tool for estimating OS in ESCC patients.
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Affiliation(s)
- Haiyang Hu
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Jun Zhang
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Hang Yan
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Chao Qin
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Haiyang Guo
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Chengdu University of TCM, Chengdu, China
| | - Tao Liu
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
| | - Shengjie Tang
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Haining Zhou
- Department of Thoracic Surgery, Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
- Institute of Surgery, Graduate School, Zunyi Medical University, Zunyi, China
- *Correspondence: Haining Zhou,
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Lin W, Lu X, Yang H, Huang L, Huang W, Tang Y, Liu S, Wang H, Zhang Y. Metabolic heterogeneity protects metastatic mucosal melanomas cells from ferroptosis. Int J Mol Med 2022; 50:124. [PMID: 36004461 PMCID: PMC9448297 DOI: 10.3892/ijmm.2022.5180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022] Open
Abstract
Cancer heterogeneity has been proposed to be one of the main causes of metastatic dissemination and therapy failure. However, the underlying mechanisms of this phenomenon remain poorly understood. Melanoma is an aggressive malignancy with a high heterogeneity and metastatic potential. Therefore, the present study investigated the possible association between cancer heterogeneity and metastasis in melanoma. In total, two novel Chinese oral mucosal melanoma (COMM) cell lines, namely COMM-1 and COMM-2, were established for exploring methods into preventing the loss of cellular heterogeneity caused by long-term cell culture. Each cell line was grown under two different models of culture, which yielded two subtypes, one exhibited an adhesive morphology (COMM-AD), whereas the other was grown in suspension (COMM-SUS). Compared with the COMM-AD cells, the COMM-SUS cells exhibited higher metastatic capacities and autofluorescence. Further investigations indicated that the COMM-SUS cells exhibited metabolic reprogramming by taking up lactate produced by COMM-AD cells at increased levels to accumulate NADH through monocarboxylate transporter 1, whilst also increasing NADPH levels through the pentose phosphate pathway (PPP). Additionally, increased NADH and NADPH levels in the COMM-SUS cells, coupled with the upregulation of the anti-ferroptotic proteins, glutathione peroxidase 4 and ferroptosis suppressor protein 1, enabled them to resist ferroptotic cell death induced by oxidative stress during hematogenous dissemination. The inhibition of ferroptosis was found to substantially increase the metastatic capacity of COMM-AD cells. Furthermore, suppressing lactate uptake and impairing PPP activation significantly decreased the metastatic potential of the COMM-SUS cells. Thus, the present study on metabolic heterogeneity in COMM cells potentially provides a novel perspective for exploring this mechanism underlying cancer metastasis.
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Affiliation(s)
- Weifan Lin
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat‑sen University, Guangzhou, Guangdong 510006, P.R. China
| | - Xiangwan Lu
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat‑sen University, Guangzhou, Guangdong 510006, P.R. China
| | - Hang Yang
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat‑sen University, Guangzhou, Guangdong 510006, P.R. China
| | - Linxuan Huang
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat‑sen University, Guangzhou, Guangdong 510006, P.R. China
| | - Wuheng Huang
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat‑sen University, Guangzhou, Guangdong 510006, P.R. China
| | - Yuluan Tang
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat‑sen University, Guangzhou, Guangdong 510006, P.R. China
| | - Situn Liu
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat‑sen University, Guangzhou, Guangdong 510006, P.R. China
| | - Hua Wang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guanghua Hospital of Stomatology, Sun Yat‑sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Yan Zhang
- MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat‑sen University, Guangzhou, Guangdong 510006, P.R. China
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[Prognostic significance red blood cell distribution width in myelodysplastic syndromes]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2022; 43:686-690. [PMID: 36709156 PMCID: PMC9593014 DOI: 10.3760/cma.j.issn.0253-2727.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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19
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Yoshida N, Horinouchi T, Eto K, Harada K, Sawayama H, Imamura Y, Iwatsuki M, Ishimoto T, Baba Y, Miyamoto Y, Watanabe M, Baba H. Prognostic Value of Pretreatment Red Blood Cell Distribution Width in Patients With Esophageal Cancer Who Underwent Esophagectomy: A Retrospective Study. ANNALS OF SURGERY OPEN 2022; 3:e153. [PMID: 37601607 PMCID: PMC10431288 DOI: 10.1097/as9.0000000000000153] [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: 09/08/2021] [Accepted: 03/03/2022] [Indexed: 11/27/2022] Open
Abstract
Objective This comprehensive analysis aimed to elucidate the mechanism underlying how high pretreatment red blood cell distribution width (RDW) reflects poor prognosis after esophagectomy for esophageal cancer. Background Several cohort studies have reported that preoperative RDW might be a predictive marker for poor prognosis after esophagectomy; however, the underlying mechanism of this relationship has not been elucidated. Methods This study included 626 patients with esophageal cancer who underwent esophagectomy between April 2005 and November 2020. A retrospective investigation of the association between pretreatment RDW and clinicopathological features, blood data, short-term outcomes, and prognosis was conducted using a prospectively entered institutional clinical database and the latest follow-up data. Results Of 626 patients, 87 (13.9%) had a high pretreatment RDW. High RDW was significantly associated with several disadvantageous characteristics regarding performance status, the American Society of Anesthesiologists physical status, respiratory comorbidity, and nutritional status. Similarly, high RDW correlated with frequent postoperative morbidities (respiratory morbidity and reoperation; P = 0.022 and 0.034, respectively), decreased opportunities for adjuvant chemotherapy (P = 0.0062), and increased death from causes other than esophageal cancer (P = 0.046). Finally, RDW could be an independent predictor of survival after esophagectomy (hazard ratio, 1.47; 95% confidence interval, 1.009-2.148; P = 0.045). Conclusion High pretreatment RDW reflected various adverse backgrounds and it could be a surrogate marker of poor prognosis in patients who have undergone esophagectomy for esophageal cancer.
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Affiliation(s)
- Naoya Yoshida
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Division of Translational Research and Advanced Treatment against Gastrointestinal Cancer, Kumamoto University, Kumamoto, Japan
| | - Tomo Horinouchi
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kojiro Eto
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kazuto Harada
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Sawayama
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yu Imamura
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masaaki Iwatsuki
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takatsugu Ishimoto
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Division of Translational Research and Advanced Treatment against Gastrointestinal Cancer, Kumamoto University, Kumamoto, Japan
| | - Yoshifumi Baba
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuji Miyamoto
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masayuki Watanabe
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hideo Baba
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Han S, Qu FW, Wang PF, Liu YX, Li SW, Yan CX. Development and Validation of a Nomogram Model Based on Hematological Indicators for Predicting the Prognosis of Diffused Gliomas. Front Surg 2022; 9:803237. [PMID: 35495765 PMCID: PMC9043458 DOI: 10.3389/fsurg.2022.803237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/08/2022] [Indexed: 01/23/2023] Open
Abstract
Background Diffused gliomas are aggressive malignant brain tumors. Various hematological factors have been proven to predict the prognosis of patients with gliomas. The aim of this study is to integrate these hematological markers and develop a comprehensive system for predicting the prognosis of patients with gliomas. Method This retrospective study included 723 patients pathologically diagnosed with diffused gliomas. Hematological indicators were collected preoperatively, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), albumin globulin ratio (AGR), platelet distribution width (PDW), red blood cell distribution width (RDW), fibrinogen (FIB), and prognostic nutritional index (PNI). Least absolute shrinkage and selection operator (LASSO) Cox was applied to screen the hematological indicators for a better prediction of patients' prognosis and to build an inflammation-nutrition score. A nomogram model was developed to predict the overall survival (OS), which included age, tumor grade, IDH-1 mutations, and inflammation-nutrition score. Result Patients were randomly divided into a primary cohort (n = 509) and a validation cohort (n = 214). There was no difference in age and IDH-1 mutation frequency between the cohorts. In the primary cohort, NLR, LMR, AGR, FIB, and PNI were selected to build an inflammation nutrition score. Patients with a high-risk inflammation-nutrition score had a short median OS of 17.40 months compared with 27.43 months in the low-risk group [HR 2.54; 95% CI (1.91–3.37); p < 0.001]. Moreover, age, tumor grade, IDH-1 mutations, and inflammation-nutrition score were independent prognostic factors in the multivariate analysis and thus were included in the nomogram model. The nomogram model showed a high prediction value with a Harrell's concordance index (C-index) of 0.75 [95% CI (0.72–0.77)]. The validation cohort supported these results. Conclusion The prognostic nomogram model provided a high prognostic predictive power for patients with gliomas.
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Affiliation(s)
- Song Han
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Fang-wen Qu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
- Grade 2018, Medical College, Qingdao University, Qingdao, China
| | - Peng-fei Wang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Ying-xin Liu
- Grade 2018, Medical College, Qingdao University, Qingdao, China
| | - Shou-wei Li
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Chang-xiang Yan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
- *Correspondence: Chang-xiang Yan
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Mota SDS, Otaño SS, Murta EFC, Nomelini R. Blood count and fasting blood glucose level in the assessment of prognosis and survival in advanced cervical cancer. Rev Assoc Med Bras (1992) 2022; 68:234-238. [PMID: 35239888 DOI: 10.1590/1806-9282.20210997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/24/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The objective of this study was to verify whether the parameters of the blood count and the fasting glucose level before treatment are related to prognosis and survival in cervical cancer (IIB-IVB staging). METHODS Patients with cervical cancer (stages IIB-IVB) were evaluated (n=80). Age, parity, staging, histological grade, histological type, hemoglobin, red blood cells, hematocrit, neutrophil, lymphocyte and platelet counts, red blood cell distribution width, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, fasting glucose levels, overall survival, and disease-free survival were evaluated. The results of laboratory parameters were compared using the Mann-Whitney U test. Receiver operating characteristic curve was used to obtain the area under the curve and determine the best cutoff values for each parameter. Survival was verified by using the Kaplan-Meier method, followed by the log-rank test. The level of significance was ≤0.05. RESULTS Regarding staging, lower hemoglobin values (p=0.0013), red blood cells (p=0.009), hematocrit (p=0.0016), higher leukocytes (p=0.0432), neutrophils (p=0.0176), platelets (p=0.0140), red blood cell distribution width (RDW) (p=0.0073), neutrophil-lymphocyte ratio (p=0.0039), platelet-lymphocyte ratio (p=0.0006), and fasting glucose level (p=0.0278) were found in IIIA-IVB compared with IIB staging. Shorter disease-free survival was associated with hemoglobin ≤12.3 g/dl (p=0.0491), hematocrit ≤38.5% (p=0.05), neutrophil-lymphocyte ratio >2.9 (p=0.0478), and platelet-lymphocyte ratio >184.9 (p=0.0207). Shorter overall survival was associated with hemoglobin ≤12.3 g/dl (p=0.0131), hematocrit ≤38.5% (p=0.0376), neutrophil-lymphocyte ratio >2.9 (p=0.0258), and platelet-lymphocyte ratio >184.9 (p=0.0038). CONCLUSION The analysis of these low-cost and easily accessible parameters could be a way to monitor patients in order to predict treatment failures and act as early as possible.
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Affiliation(s)
- Sâmela Daiere Soares Mota
- Universidade Federal do Triângulo Mineiro, Research Institute of Oncology, Department of Gynecology and Obstetrics - Uberaba (MG), Brazil
| | - Sérgio Santana Otaño
- Universidade Federal do Triângulo Mineiro, Research Institute of Oncology, Department of Gynecology and Obstetrics - Uberaba (MG), Brazil
| | - Eddie Fernando Candido Murta
- Universidade Federal do Triângulo Mineiro, Research Institute of Oncology, Department of Gynecology and Obstetrics - Uberaba (MG), Brazil
| | - Rosekeila Nomelini
- Universidade Federal do Triângulo Mineiro, Research Institute of Oncology, Department of Gynecology and Obstetrics - Uberaba (MG), Brazil
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22
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Li Y, Li Z, Zhang G. Clinical Utility of Red Blood Cell Distribution Width for the Diagnosis and Prognosis of Cervical Cancer. Int J Gen Med 2022; 15:2597-2606. [PMID: 35282652 PMCID: PMC8910443 DOI: 10.2147/ijgm.s354569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/17/2022] [Indexed: 12/13/2022] Open
Abstract
Background The width of red blood cell distribution (RDW) is correlated with some diseases, but its clinical value and prognostic role in cervical cancer is unclear. Methods We used receiver operating characteristic curves to evaluate the diagnostic ability of RDW and other clinical parameters in cervical cancer based on a case–control design. Using retrospective data, we explored the correlation of RDW with overall (OS) and progression-free (PFS) survival using Kaplan–Meier analysis and univariate and multivariate Cox regression with the hazard ratio (HR) and 95% confidence interval (CI). A restricted cubic plot was used to evaluate the nonlinear association between RDW and prognosis risk. Results RDW was significantly higher in cases than in controls (14.6±1.7 vs 12.5±1.8, P<0.001). It showed high diagnostic accuracy for cervical cancer, with a sensitivity of 79.3%, specificity of 65.6%, and area under the curve of 0.802 (95% CI, 0.775–0.827) with a cutoff value of 13.88. There was a significant positive correlation between RDW and C-reactive protein (r=0.434, P=0.023). Multivariate Cox regression indicated that it was independently associated with a poorer PFS (HR, 2.05; 95% CI, 1.25–3.18, P<0.001) and OS (HR, 2.73; 95% CI, 1.61–4.64, P<0.001). RDW>14.66 showed a nonlinear increased risk for a poor PFS and OS. Conclusion RDW is an easy, quick, and inexpensive tool for the early detection and risk management of cervical cancer. A greater RDW is associated with a poor prognosis in cervical cancer.
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Affiliation(s)
- Yanyan Li
- Department of Nursing, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
| | - Zhanzhan Li
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
| | - Guangying Zhang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
- Correspondence: Guangying Zhang, Department of Oncology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Kaifu District, Changsha, Hunan Province, 410008, People’s Republic of China, Email
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23
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Tao Y, Zhou Y, Chen H, Qin Y, He X, Liu P, Zhou S, Yang J, Zhou L, Zhang C, Yang S, Gui L, Shi Y. Prognostic role of red blood cell distribution width and platelet/lymphocyte ratio in early-stage classical Hodgkin lymphoma. Future Oncol 2022; 18:1817-1827. [PMID: 35179068 DOI: 10.2217/fon-2021-1398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: To investigate the prognostic role of red blood cell distribution width (RDW) and platelet/lymphocyte ratio (PLR) in early-stage classical Hodgkin lymphoma (cHL). Materials & methods: Data from 402 patients with newly diagnosed early-stage cHL were retrospectively collected. The impact of factors on complete response (CR) rate and freedom from progression (FFP) was analyzed. Results: High PLR was associated with lower CR, but high RDW was not. The univariate analysis showed that RDW and PLR were predictive of FFP. On multivariate analysis, high PLR was an independent risk factor for inferior FFP. Subgroup analysis and a prognostic model for FFP based on PLR validated the prognostic role of PLR. Conclusion: PLR was a robust prognostic factor for newly diagnosed early-stage cHL.
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Affiliation(s)
- Yunxia Tao
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Yu Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Haizhu Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Yan Qin
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Xiaohui He
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Peng Liu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Shengyu Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Jianliang Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Liqiang Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Changgong Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Sheng Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Lin Gui
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
| | - Yuankai Shi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, China
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Su R, Zhu J, Wu S, Luo H, He Y. Prognostic Significance of Platelet (PLT) and Platelet to Mean Platelet Volume (PLT/MPV) Ratio During Apatinib Second-Line or Late-Line Treatment in Advanced Esophageal Squamous Cell Carcinoma Patients. Technol Cancer Res Treat 2022; 21:15330338211072974. [PMID: 35072577 PMCID: PMC8808027 DOI: 10.1177/15330338211072974] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Apatinib has a certain efficacy for advanced esophageal squamous cell carcinoma (ESCC). This study aimed to investigate the prognostic significance of platelet (PLT) and platelet to mean platelet volume (PLT/MPV) ratio for advanced ESCC patients with apatinib second-line or late-line treatment. Methods: A retrospective study included 80 patients with advanced ESCC who received Apatinib ≥ 2 lines targeted therapy. We collected baseline clinical characteristics and blood parameters from the patients. Kaplan-Meier plots and univariate and multivariate analysis were used to find the factors related to progression-free survival (PFS). Results: The optimal cut-off values of PLT and PLT/MPV ratio were determined by X-tile software. Kaplan-Meier analysis demonstrated that patients in the high PLT group had better PFS than those in the low PLT group (156 d vs 80 d, P <.001), and patients in the high PLT/MPV ratio group had better PFS than those in low PLT/MPV ratio group (157 d vs 85 d, P <.001). Univariate analysis revealed pretreatment PLT and PLT/MPV ratio were significantly correlated with PFS. Multivariate analysis revealed high levels of pretreatment PLT/MPV ratio was an independent predictor of longer PFS (HR: 0.257, 95% CI: 0.089-0.743, P = .012). Conclusion: High levels of baseline PLT and PLT/MPV may indicate a better prognosis in apatinib ≥ 2 lines treatment for advanced ESCC patients.
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Affiliation(s)
- Rixin Su
- Anhui Provincial Hospital Affiliated to Anhui Medical University,
Luyang District, Hefei, China
| | - Jingya Zhu
- Anhui Provincial Hospital Affiliated to Anhui Medical University,
Luyang District, Hefei, China
| | - Shusheng Wu
- West Branch of the First Affiliated Hospital of University of
Science and Technology of China, Shushan District, Hefei, China Rixin Su and Jingya
Zhu contributed equally to this work and should be considered co-first
authors
| | - Huiqin Luo
- West Branch of the First Affiliated Hospital of University of
Science and Technology of China, Shushan District, Hefei, China Rixin Su and Jingya
Zhu contributed equally to this work and should be considered co-first
authors
| | - Yifu He
- West Branch of the First Affiliated Hospital of University of
Science and Technology of China, Shushan District, Hefei, China Rixin Su and Jingya
Zhu contributed equally to this work and should be considered co-first
authors
- Yifu He, West Branch of the First
Affiliated Hospital of University of Science and Technology of China, No. 107
Huanhudong Road, Shushan District, Hefei, China.
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25
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Gui Z, Liu H, Shi W, Xu Y, Qian H, Wang F. A Nomogram for Predicting the Risk of Radiotherapy-Related Esophageal Fistula in Esophageal Cancer Patients. Front Oncol 2022; 11:785850. [PMID: 35117991 PMCID: PMC8803635 DOI: 10.3389/fonc.2021.785850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background To construct and validate a nomogram for predicting the risk of esophageal fistula in esophageal cancer patients receiving radiotherapy. Methods A retrospective nested case–control study was performed, in which a total of 81 esophageal fistula patients and 243 controls from 2014 to 2020 in the First Affiliated Hospital of Anhui Medical University were enrolled. Factors included in the nomogram were determined by univariate and multiple logistic regression analysis. The following methods including ROC curve, C-index, calibration curves, Brier score, and decision curve analysis (DCA) were adopted to evaluate this nomogram. Results Multivariate logistic regression analysis showed that T4 stage, level 4 stenosis, ulcerative esophageal cancer, prealbumin, and maximum diameters of GTV and NLR were the independent risk factors of esophageal fistula. Accordingly, a nomogram incorporating the aforementioned six parameters was constructed. The AUC was 0.848 (95% CI 0.901–0.895), indicating a high prediction accuracy of this nomogram. Further evaluation of this model showed that the C-index was 0.847, while the bias-corrected C-index after internal validation was 0.833. The Brier score was 0.127. The calibration curves presented good concordance, and the DCA revealed promising clinical application. Conclusions The nomogram presents accurate and applicable prediction for the esophageal fistula risk in esophageal cancer patients receiving radiotherapy.
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26
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Han Z, Hu Z, Zhao Q, Xue W, Duan G. The advanced lung cancer inflammation index predicts outcomes of patients with non-small cell lung cancer following video-assisted thoracic surgery. J Int Med Res 2021; 49:3000605211062442. [PMID: 34871517 PMCID: PMC8652187 DOI: 10.1177/03000605211062442] [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: 12/16/2022] Open
Abstract
OBJECTIVE The advanced lung cancer inflammation index (ALI) predicts overall survival (OS) in patients with advanced lung cancer. However, few studies have tested ALI's prognostic effect in patients with non-small cell lung cancer (NSCLC) following video-assisted thoracic surgery (VATS), especially patients at stage III. This study investigated the relationship between ALI and outcomes of patients with NSCLC following VATS. METHODS We retrospectively examined 339 patients with NSCLC who underwent VATS at Hebei General Hospital, China. Preoperative clinical and laboratory parameters were collected and analyzed. Optimal cutoff values of potential prognostic factors, including ALI, were determined. Kaplan-Meier and Cox regression analyses were used to determine each factor's prognostic value. RESULTS The median OS was 31 months. The optimal cutoff value for ALI was 41.20. Patients with high ALI (≥41.20) displayed increased OS (33.87 vs. 30.24 months), higher survival rates, and milder clinical characteristics. Univariate and multivariate analyses showed a significant correlation between ALI and the prognosis of patients with NSCLC, including those at stage IIIA, who underwent VATS. CONCLUSIONS Low ALI correlated with poor outcomes in patients with NSCLC following VATS. Preoperative ALI might be a potential prognostic biomarker for patients with NSCLC following VATS, including patients at stage IIIA.
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Affiliation(s)
- Zhaohui Han
- Department of Thoracic Surgery, 117872Hebei General Hospital, Hebei General Hospital, Shijiazhuang, China.,Graduate School, 261761Hebei North University, Hebei North University, Zhangjiakou, China
| | - Zhonghui Hu
- Department of Thoracic Surgery, 117872Hebei General Hospital, Hebei General Hospital, Shijiazhuang, China
| | - Qingtao Zhao
- Department of Thoracic Surgery, 117872Hebei General Hospital, Hebei General Hospital, Shijiazhuang, China
| | - Wenfei Xue
- Department of Thoracic Surgery, 117872Hebei General Hospital, Hebei General Hospital, Shijiazhuang, China
| | - Guochen Duan
- Department of Thoracic Surgery, 117872Hebei General Hospital, Hebei General Hospital, Shijiazhuang, China.,Department of Thoracic Surgery, Children's Hospital of Hebei Province, Shijiazhuang, China
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27
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Wang J, Xiao Q, Li Y. ΔRDW: A Novel Indicator with Predictive Value for the Diagnosis and Treatment of Multiple Diseases. Int J Gen Med 2021; 14:8667-8675. [PMID: 34849010 PMCID: PMC8627260 DOI: 10.2147/ijgm.s339945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/28/2021] [Indexed: 12/22/2022] Open
Abstract
Elevated red blood cell distribution width (RDW) is a powerful predictor of poor prognosis in a variety of diseases, but a single measurement of RDW cannot reflect the dynamic change of diseases. ΔRDW, as a risk stratification tool, can be used to record changes in RDW before and after treatment; also, it allows investigators to name the unit change of RDW in the studied population. So far, there have been few relevant studies on the predictive value of ΔRDW for different diseases; this article aims to review the studies and summaries of the current understandings on the correlation between ΔRDW and disease outcomes.
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Affiliation(s)
- Jingsheng Wang
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People's Republic of China
| | - Qiang Xiao
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People's Republic of China
| | - Yuanmin Li
- Department of Cardiology, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, People's Republic of China
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28
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Wang R, He M, Zhang J, Wang S, Xu J. A Prognostic Model Incorporating Red Cell Distribution Width to Platelet Ratio for Patients with Traumatic Brain Injury. Ther Clin Risk Manag 2021; 17:1239-1248. [PMID: 34858027 PMCID: PMC8631984 DOI: 10.2147/tcrm.s337040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/06/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As an inflammation-based marker, red cell distribution width to platelet ratio (RPR) has been verified to be associated with disease severity and outcome in many clinical settings. We designed this study to evaluate the prognostic value of RPR in patients with traumatic brain injury (TBI). METHODS A total of 420 patients admitted with TBI were included in this study. Laboratory and clinical data were collected from an electronic medical record system. Univariate and multivariate logistic regression analyses were sequentially performed to discover risk factors of in-hospital mortality. Receiver operating characteristic (ROC) curves were drawn to confirm the predictive value of different markers including RPR in training set and testing set. RESULTS Non-survivors had higher level of RPR than survivors (P<0.001). Logistic regression analysis showed that RPR was significantly associated with mortality even after adjusting for confounding factors (P<0.001). The area under the ROC curve (AUC) value of Glasgow Coma Scale (GCS) for predicting mortality was 0.761 and 0775 in training set and testing set, respectively. And the constructed predictive model incorporating RPR had the highest AUC value of 0.858 and 0.884 in training set and testing set. CONCLUSION RPR is significantly associated with mortality in TBI patients. Utilizing RPR to construct a predictive model is valuable to evaluate prognosis of TBI patients.
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Affiliation(s)
- Ruoran Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Min He
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Jing Zhang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Shaobo Wang
- Department of Infectious Diseases, Xi’an Hospital of Traditional Chinese Medicine, Xi’an, Shannxi Province, People’s Republic of China
| | - Jianguo Xu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
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The potential value of the neutrophil to lymphocyte ratio for early differential diagnosis and prognosis assessment in patients with aortic dissection. Clin Biochem 2021; 97:41-47. [PMID: 34391696 DOI: 10.1016/j.clinbiochem.2021.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The aim of the study was to assess the diagnostic performance and clinical utility of the neutrophil to lymphocyte ratio (NLR) in patients with suspected aortic dissection (AD) and investigate its role in predicting in-hospital mortality in AD. METHODS NLR values were calculated and compared in 467 consecutive patients with initially suspected AD. A receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was used to evaluate the discriminative accuracy and predictive capability of the NLR for AD. Clinical utility was determined by decision curve analysis (DCA). The association between NLR and in-hospital mortality was investigated by logistic regression analyses in patients diagnosed with AD. RESULTS The NLR was significantly elevated in patients with AD, and the optimal cut-off point for the NLR to distinguish AD from other acute chest pain diseases was 5.67 [AUC (95% CI): 0.877 (0.844-0.905)]. We recommended an NLR of 2.43 as the appropriate cut-off point with 96.9% sensitivity and a negative likelihood ratio (LR) of 0.09 to satisfy clinical requirements for diagnosis. DCA showed that the use of NLR had a positive net benefit. The deceased patients with AD had a higher NLR than the discharged patients. Moreover, the NLR was an independent predictor of in-hospital mortality for AD [adjusted odds ratio (OR): 1.084 (1.029-1.142)], and patients with higher NLR values tended to have a higher risk of in-hospital mortality. The optimal cut-off point for the NLR to predict in-hospital mortality was 9.20 [AUC (95% CI): 0.695 (0.619-0.765)]. CONCLUSIONS As an easily available and inexpensive parameter, the NLR could serve as a valuable clinical biomarker for early differential diagnosis and prognosis assessment of AD.
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30
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Xi Y, Bai Y. Diagnostic value of red blood cell distribution width, platelet distribution width, and red blood cell distribution width to platelet ratio in children with hemophagocytic lymphohistiocytosis. J Clin Lab Anal 2021; 35:e23909. [PMID: 34273201 PMCID: PMC8418495 DOI: 10.1002/jcla.23909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/26/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background To investigate whether red blood cell distribution width (RDW), platelet distribution width (PDW), and red blood cell distribution width to platelet ratio (RPR) can serve as biomarkers to distinguish hemophagocytic lymphohistiocytosis (HLH) from sepsis in children. Methods This is a retrospective study, involving 71 HLH patients, 105 sepsis patients, and 88 normal controls from January 2018 to December 2019. RDW, PDW, and RPR values were obtained from peripheral blood samples before standard treatment. The clinical differential diagnostic values of RDW, PDW, and RPR were analyzed by receiver operating characteristic (ROC) curve. In addition, peripheral blood samples after treatment from HLH patients were also collected for the same analyses. Results RDW, PDW, and RPR levels of the HLH patients were significantly higher than those of sepsis and normal controls (p < 0.001). In ROC curve analysis of the RDW, PDW, and RPR for diagnosis of HLH, the area under the curve (AUC) could reach to 0.7799 (95% CI = 0.7113–0.8486), 0.7835 (95% CI = 0.7093–0.8577), and 0.9268 (95% CI = 0.8886–0.9649), respectively. When using the criteria of RDW >13.75, PDW >13.30, and RPR >0.08, the sensitivity was 76.06%, 67.61%, and 84.51%, while the specificity was 68.57%, 85.71%, and 87.62%, respectively. After treatment of HLH patients, PDW and RPR were significantly reduced (p < 0.001). Conclusions This study shows that RDW, PDW, and RPR, which can be easily and cheaply detected, are novel indicators for differential diagnosis of HLH. PDW and RPR are useful indices for monitoring the effects of treatment on HLH.
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Affiliation(s)
- Ya Xi
- Department of Central Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yongying Bai
- Department of Clinical Laboratory, Branch of National Clinical Research Center for Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Zhang C, Li XK, Hu LW, Zheng C, Cong ZZ, Xu Y, Luo J, Wang GM, Gu WF, Xie K, Luo C, Shen Y. Predictive value of postoperative C-reactive protein-to-albumin ratio in anastomotic leakage after esophagectomy. J Cardiothorac Surg 2021; 16:133. [PMID: 34001160 PMCID: PMC8130324 DOI: 10.1186/s13019-021-01515-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/07/2021] [Indexed: 12/27/2022] Open
Abstract
Introduction Among the many possible postoperative complications, anastomotic leakage (AL) is the most common and serious. Therefore, the purpose of this study was to explore the ability of various inflammatory and nutritional markers to predict postoperative AL in patients after esophagectomy. Methods A total of 273 patients were retrospectively evaluated and enrolled into this study. Perioperative, surgery-related, tumor-related and laboratory tests data were extracted and analyzed. The discriminatory ability and optimal cut-off value was evaluated according to the receiver operating characteristic (ROC) curve analysis. Univariate and multivariate analyses were performed to access the potential risk factors for AL. Results The overall incidence of AL was 12.5% (34/273). C-reactive protein-to-albumin ratio (CRP/ALB ratio) [AUC 0.943 (95% confidence interval (CI) = 0.911–0.976, p < 0.001)] and operation time [AUC 0.747 (95% CI = 0.679–0.815, p < 0.001)] had the greatest discrimination on AL prediction. Multivariate analysis demonstrated that CRP/ALB ratio and operation time were two independent risk factors for AL, and CRP/ALB ratio (OR = 102.909, p < 0.001) had an advantage over operation time (OR = 9.363, p = 0.020; Table 3). Conclusion Operation time and postoperative CRP/ALB ratio were two independent predictive indexes for AL. Postoperative CRP/ALB ratio greater than 3.00 indicated a high risk of AL. For patients with abnormal postoperative CRP/ALB ratio, early non-operative treatment or surgical intervention are needed to reduce the serious sequelae of AL.
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Affiliation(s)
- Chi Zhang
- Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiao Kun Li
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Medicine, Southeast University, Nanjing, China.
| | - Li Wen Hu
- Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chao Zheng
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhuang Zhuang Cong
- Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yang Xu
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Jing Luo
- Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Gao Ming Wang
- Department of Thoracic Surgery, Xuzhou Central Hospital, Xuzhou School of Clinical Medicine of Nanjing Medical University, Nanjing, China
| | - Wen Feng Gu
- Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Kai Xie
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Chao Luo
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yi Shen
- Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. .,Department of Cardiothoracic Surgery, Jinling Hospital, School of Medicine, Southeast University, Nanjing, China. .,Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical Medicine, Nanjing Medical University, Nanjing, China. .,Department of Thoracic Surgery, Xuzhou Central Hospital, Xuzhou School of Clinical Medicine of Nanjing Medical University, Nanjing, China. .,Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical Medicine, Southern Medical University, Guangzhou, China.
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Jiang H, Jiang W, Tan L, Yu Q, Liu F, Huang Y, He J, Zhou S. The predictive value of pretreatment haemoglobin-to-red cell distribution width ratio for overall survival of patients with advanced non-small cell lung cancer: a propensity score matching analysis. J Int Med Res 2021; 49:3000605211004229. [PMID: 33823630 PMCID: PMC8033480 DOI: 10.1177/03000605211004229] [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] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the prognostic value of pretreatment haemoglobin-to-red cell
distribution width radio (HRR) in predicting overall survival (OS) in
patients with advanced non-small cell lung cancer (NSCLC). Methods This retrospective study analysed patients with advanced NSCLC. Kaplan–Meier
survival analysis and Cox proportional hazards regression analysis were
conducted to evaluate the predictive value of HRR for OS. A propensity
matching analysis was used to reduce the impact of other confounding factors
on the results. Results A total of 448 patients were enrolled in the study. The median HRR was 0.984,
which was used as the cut-off value. Regardless of matching or not, a lower
HRR was correlated with an unfavourable risk of death. After propensity
matching, univariate and multivariate analysis showed that HRR was an
independent factor for the prognosis of NSCLC (hazard ratio [HR] 1.55, 95%
confidence interval [CI] 1.17, 2.04; HR 1.57, 95% CI, 1.17, 2.10;
respectively). Kaplan–Meier analysis showed that low HRR was associated with
shortened OS. The relationship between HRR and the risk of death was
consistent across all patient subgroups after stratification by subgroup
analysis. Conclusions These findings showed that a lower pretreatment HRR could be a potentially
valuable prognostic factor in patients with advanced NSCLC.
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Affiliation(s)
- Huiqin Jiang
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Wei Jiang
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Liping Tan
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Qitao Yu
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Feiwen Liu
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Yucong Huang
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Jianbo He
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Shaozhang Zhou
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
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Cui K, Hu S, Mei X, Cheng M. Innate Immune Cells in the Esophageal Tumor Microenvironment. Front Immunol 2021; 12:654731. [PMID: 33995371 PMCID: PMC8113860 DOI: 10.3389/fimmu.2021.654731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/13/2021] [Indexed: 01/10/2023] Open
Abstract
Esophageal cancer (EC) is one of the most common mucosa-associated tumors, and is characterized by aggressiveness, poor prognosis, and unfavorable patient survival rates. As an organ directly exposed to the risk of foodborne infection, the esophageal mucosa harbors distinct populations of innate immune cells, which play vital roles in both maintenance of esophageal homeostasis and immune defense and surveillance during mucosal anti-infection and anti-tumor responses. In this review, we highlight recent progress in research into innate immune cells in the microenvironment of EC, including lymphatic lineages, such as natural killer and γδT cells, and myeloid lineages, including macrophages, dendritic cells, neutrophils, myeloid-derived suppressor cells, mast cells and eosinophils. Further, putative innate immune cellular and molecular mechanisms involved in tumor occurrence and progression are discussed, to highlight potential directions for the development of new biomarkers and effective intervention targets, which can hopefully be applied in long-term multilevel clinical EC treatment. Fully understanding the innate immunological mechanisms involved in esophageal mucosa carcinogenesis is of great significance for clinical immunotherapy and prognosis prediction for patients with EC.
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Affiliation(s)
- Kele Cui
- Department of Clinical Laboratory, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, China
- Cancer Immunotherapy Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Shouxin Hu
- Department of Geriatrics, Gerontology Institute of Anhui Province, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, China
- Cancer Immunotherapy Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xinyu Mei
- Department of Thoracic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Min Cheng
- Department of Geriatrics, Gerontology Institute of Anhui Province, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, China
- Cancer Immunotherapy Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Dragomir R, Dragomir AS, Negru A, Săftescu S, Popovici D, Schenker M, Lupușoru R, Negru Ș. Role of combining neutrophil-to-lymphocyte ratio and pretreatment body mass index in predicting progression-free survival in patients with non-small cell lung cancer treated with nivolumab. Exp Ther Med 2021; 21:526. [PMID: 33815599 PMCID: PMC8014982 DOI: 10.3892/etm.2021.9958] [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] [Received: 12/24/2020] [Accepted: 01/26/2021] [Indexed: 01/04/2023] Open
Abstract
Identifying markers capable of predicting outcomes in lung cancer patients treated with nivolumab represents a growing research interest. The combination of neutrophil-to-lymphocyte ratio (NLR) and body mass index (BMI) may help predict treatment efficacy. Thus, the present study aimed to investigate the influence of NLR and BMI on progression-free survival (PFS) in non-small-cell lung cancer (NSCLC) patients treated with nivolumab. A retrospective study was made on 80 patients with NSCLC that were treated with nivolumab at the OncoHelp Oncology Center, Timisoara, Romania after platinum-based chemotherapy, from January 2018 to April 2020. Patients were administered nivolumab at a dose of 3 mg/m2 or 240 mg total dose, every 2 weeks. The predictive impact of NLR (baseline at 2 and 4 weeks after the start of nivolumab) and BMI for disease progression was assessed. Median PFS for subjects with NLR <3 before treatment was 18.5 weeks, while in subjects with NLR ≥3 was 14 weeks (P=0.50). Median PFS for subjects with NLR2 <3 at 2 weeks after treatment was 21 weeks, while in subjects with NLR2 ≥3, PFS was 14 weeks (P=0.17). Median PFS for subjects with NLR4 <3 at 4 weeks after treatment was 23 weeks, while in subjects with NLR4 ≥3, PFS was 19 weeks (P=0.33). Multivariate analysis for the association with PFS showed that baseline NLR, male sex and BMI were associated independently, thus we could develop a significant statistical model [AUROC=0.76, 95% CI (0.45-0.89), P=0.03], a new predictive score for PFS. The assessment of NLR and BMI may represent simple and useful biomarkers; combining them and taking into consideration the male sex may predict PFS in patients with advanced NSCLC treated with nivolumab.
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Affiliation(s)
- Radu Dragomir
- Department of Obstetrics and Gynecology, 'Victor Babeș' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Adelina Silvana Dragomir
- Department of Oncology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alina Negru
- Department of Cardiology, 'Victor Babeș' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Sorin Săftescu
- Department of Oncology, 'Victor Babeș' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Dorel Popovici
- Department of Oncology, 'Victor Babeș' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Michael Schenker
- Department of Oncology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Raluca Lupușoru
- II Department of Internal Medicine, Gastroenterology and Hepatology Discipline, 'Victor Babeș' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania.,Department of Functional Sciences, Medical Informatics and Biostatistics Discipline, Center for Modeling Biological Systems and Data Analysis, 'Victor Babeș' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Șerban Negru
- Department of Oncology, 'Victor Babeș' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
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Kamarajah SK, Marson EJ, Zhou D, Wyn-Griffiths F, Lin A, Evans RPT, Bundred JR, Singh P, Griffiths EA. Meta-analysis of prognostic factors of overall survival in patients undergoing oesophagectomy for oesophageal cancer. Dis Esophagus 2020; 33:5843554. [PMID: 32448903 DOI: 10.1093/dote/doaa038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/25/2020] [Accepted: 04/17/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Currently, the American Joint Commission on Cancer (AJCC) staging system is used for prognostication for oesophageal cancer. However, several prognostically important factors have been reported but not incorporated. This meta-analysis aimed to characterize the impact of preoperative, operative, and oncological factors on the prognosis of patients undergoing curative resection for oesophageal cancer. METHODS This systematic review was performed according to PRISMA guidelines and eligible studies were identified through a search of PubMed, Scopus, and Cochrane CENTRAL databases up to 31 December 2018. A meta-analysis was conducted with the use of random-effects modeling to determine pooled univariable hazard ratios (HRs). The study was prospectively registered with the PROSPERO database (Registration: CRD42018157966). RESULTS One-hundred and seventy-one articles including 73,629 patients were assessed quantitatively. Of the 122 factors associated with survival, 39 were significant on pooled analysis. Of these. the strongly associated prognostic factors were 'pathological' T stage (HR: 2.07, CI95%: 1.77-2.43, P < 0.001), 'pathological' N stage (HR: 2.24, CI95%: 1.95-2.59, P < 0.001), perineural invasion (HR: 1.54, CI95%: 1.36-1.74, P < 0.001), circumferential resection margin (HR: 2.17, CI95%: 1.82-2.59, P < 0.001), poor tumor grade (HR: 1.53, CI95%: 1.34-1.74, P < 0.001), and high neutrophil:lymphocyte ratio (HR: 1.47, CI95%: 1.30-1.66, P < 0.001). CONCLUSION Several tumor biological variables not included in the AJCC 8th edition classification can impact on overall survival. Incorporation and validation of these factors into prognostic models and next edition of the AJCC system will enable personalized approach to prognostication and treatment.
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Affiliation(s)
- Sivesh K Kamarajah
- Northern Oesophagogastric Cancer Unit, Newcastle University NHS Foundation Trust Hospitals, Newcastle upon Tyne, UK.,Institute of Cellular Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Ella J Marson
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Dengyi Zhou
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | - Aaron Lin
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Richard P T Evans
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - James R Bundred
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Pritam Singh
- Department of Upper Gastrointestinal Surgery, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Ewen A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Ge S, Lin S, Zhang L, Zeng M. The Association of Red Blood Cell Distribution Width to Platelet Count Ratio and 28-Day Mortality of Patients with Sepsis: A Retrospective Cohort Study. Ther Clin Risk Manag 2020; 16:999-1006. [PMID: 33116549 PMCID: PMC7586012 DOI: 10.2147/tcrm.s268523] [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: 06/29/2020] [Accepted: 09/11/2020] [Indexed: 12/18/2022] Open
Abstract
Background Sepsis is a life-threatening and inflammatory disease with high morbidity and mortality. Red blood cell distribution width to platelet count ratio (RPR) was known as an inflammatory biomarker and was related to poor outcomes of various diseases. Aim This study was intended to explore the association between RPR and mortality of sepsis patients. Methods A retrospective cohort study was undertaken in patients with sepsis, and the data were collected from a public database called Medical Information Mart for Intensive Care III (MIMIC-III). The primary outcome was 28-day mortality while the secondary outcomes were 90-day mortality and ICU mortality. Multivariable regression analyses, as well as interaction and stratified analyses, were conducted to investigate the relation between RPR and sepsis mortality. Results In total, we enrolled 7531 patients with 1316 deaths. RPR was independently correlated with 28-day mortality (per 0.1 increase: HR=1.04; 95% CI 1.02–1.06), 90-day mortality (per 0.1 increase: HR=1.04; 95% CI 1.03–1.06) and ICU mortality (per 0.1 increase: OR=1.06; 95% CI 1.02–1.10). Twenty-eight-day survival was worse in the high RPR (≥0.134) group according to the Kaplan–Meier curve analyses (Log rank test, p<0.001). In stratified analyses, Sequential Organ Failure Assessment (SOFA) score and length of ICU stay had interactive effects with the high RPR (≥0.134) group on 28-day mortality. Conclusion RPR is a novel biomarker that indicates poor prognosis of sepsis patients. Clinicians are required to pay more attention to those patients with high RPR.
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Affiliation(s)
- Shanhui Ge
- Department of Medical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China; Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Shan Lin
- Department of Medical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China; Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Lishan Zhang
- Department of Medical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China; Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Mian Zeng
- Department of Medical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China; Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
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Chen JL, Wu JN, Lv XD, Yang QC, Chen JR, Zhang DM. The value of red blood cell distribution width, neutrophil-to-lymphocyte ratio, and hemoglobin-to-red blood cell distribution width ratio in the progression of non-small cell lung cancer. PLoS One 2020; 15:e0237947. [PMID: 32833961 PMCID: PMC7446848 DOI: 10.1371/journal.pone.0237947] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background Lung cancer is the leading cause of cancer-related deaths worldwide, with non-small cell lung cancer (NSCLC) accounting for 85% of all lung cancer cases. Inflammation has been proven to be one of the characteristics of malignant tumors. Chronic inflammatory response mediated by cytokines in the tumor microenvironment is an important factor in tumorigenesis. The purpose of this study was to observe and evaluate the value of red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and hemoglobin-to-red blood cell distribution width ratio (HRR) in the progression of NSCLC. Methods A total of 245 patients with NSCLC, 97 patients with benign pulmonary nodules, and 94 healthy volunteers were included in this study. Factors, such as age, gender, smoking history, histological type, lymph node metastasis, distant metastasis, TNM stage, and differentiation degree were statistically analyzed. The correlation of RDW, NLR, and HRR of patients with NSCLC with other clinical experimental parameters were also analyzed. Then, the diagnostic value of RDW, NLR, and HRR in the progression of NSCLC was evaluated. Results RDW, NLR, and HRR could be used to distinguish patients with NSCLC from healthy controls (p < 0.05). In addition, only the RDW in the NSCLC group with III-IV stage was significantly different from that in the benign pulmonary nodules group (p = 0.033), while NLR and HRR could significantly distinguish patients with NSCLC and benign pulmonary nodules (p < 0.001). RDW and NLR were positively correlated with NSCLC stage, whereas HRR was negatively correlated with NSCLC stage. RDW, NLR, and HRR were also significantly associated with the differentiation degree of NSCLC (p < 0.05). The ROC curve analysis showed that the combination of RDW with NLR, HRR, and CEA could show significantly higher diagnostic value than any one marker alone (AUC = 0.925, 95% CI: 0.897–0.954, and sensitivity and specificity of 79.60% and 93.60%, respectively). Conclusion RDW, NLR, and HRR can be utilized as simple and effective biomarkers for the diagnosis and evaluation of NSCLC progression.
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Affiliation(s)
- Jin-liang Chen
- Department of Respiratory Medicine, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China
| | - Jin-nan Wu
- Postgraduate in Respiratory Medicine, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China
| | - Xue-dong Lv
- Department of Respiratory Medicine, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China
| | - Qi-chang Yang
- Department of Pathology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China
| | - Jian-rong Chen
- Department of Respiratory Medicine, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China
- * E-mail: (JC); (DZ)
| | - Dong-mei Zhang
- Department of Medical Research Center, The Second Affiliated Hospital of Nantong University, Jiangsu, People's Republic of China
- * E-mail: (JC); (DZ)
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Xing X, Deng Y, Zhu Y, Xu S, Liu J, Zhang C, Xu S, Yang J. Red cell distribution width for prognosis in patients with pulmonary embolism: A systematic review and meta‐analysis. CLINICAL RESPIRATORY JOURNAL 2020; 14:901-907. [PMID: 32568446 DOI: 10.1111/crj.13227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 05/22/2020] [Accepted: 06/11/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Xiqian Xing
- Department of Respiratory Medicine The Fourth Affiliated Hospital of Kunming Medical University, The Second People's Hospital of Yunnan Province Kunming China
| | - Yishu Deng
- Department of Respiratory Medicine The Fourth Affiliated Hospital of Kunming Medical University, The Second People's Hospital of Yunnan Province Kunming China
| | - Yun Zhu
- The People's Hospital of Yuxi CityThe 6th Affiliated Hospital of Kunming Medical University Yuxi China
| | - Shuangyan Xu
- Department of Dermatology The Second Affiliated Hospital of Kunming Medical University Kunming China
| | - Jie Liu
- Department of Respiratory Medicine The Fourth Affiliated Hospital of Kunming Medical University, The Second People's Hospital of Yunnan Province Kunming China
| | - Chunfang Zhang
- Department of Respiratory Medicine The Fourth Affiliated Hospital of Kunming Medical University, The Second People's Hospital of Yunnan Province Kunming China
| | - Shuanglan Xu
- Department of Respiratory Medicine The Fourth Affiliated Hospital of Kunming Medical University, The Second People's Hospital of Yunnan Province Kunming China
| | - Jiao Yang
- First Department of Respiratory Medicine The First Affiliated Hospital of Kunming Medical University Kunming China
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Hu J, Chen D, Wu S, Chen Y, Li R, Miao H, Wen Z. Prognostic significance of neutrophil-to-lymphocyte ratio in middle thoracic esophageal squamous cell carcinoma patients undergoing radical esophagectomy. J Thorac Dis 2020; 12:363-374. [PMID: 32274102 PMCID: PMC7139068 DOI: 10.21037/jtd.2020.01.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background It is widely accepted that the pretreatment neutrophil-to-lymphocyte ratio (NLR) is an independent predictor of prognosis in multiple malignancies, including esophageal squamous cell carcinoma (ESCC). However, its predictive value in middle thoracic esophageal carcinoma is still unclear. Therefore, the purpose of this study was to investigate the preoperative serum levels of NLR in middle thoracic esophageal carcinoma patients to clarify their clinical significance as predictors of prognosis. Methods This study investigated 556 patients with middle thoracic ESCC treated by esophagectomy from January 2010 to December 2012. The prognostic impact of serum NLR level was analyzed. A receiver operating characteristic (ROC) curve was used to identify the NLR for predicting survival. Correlation between the NLR and clinicopathological characteristics was analyzed by χ2 test. Prognostic influence was calculated by using the Kaplan-Meier method and the difference was compared by log-rank test. Cox regression analysis was performed to evaluate the significant prognostic factors. Results The cutoff value for the NLR was 2.43 ng/mL, the area under the curve was 0.553 (95% CI: 0.504–0.601; P=0.035), and the sensitivity and specificity were 53.3% and 58.7% respectively. It is demonstrated that preoperative NLR (P=0.003), T stage (P<0.001), N stage (P<0.001), surgical approach (P=0.004), and gender (P=0.008) were independent prognostic factors in middle thoracic ESCC by univariate analysis. Multivariate analysis showed that preoperative NLR (P=0.036), T stage (P=0.004), N stage (P<0.001), surgical approach (P=0.002), and age (P=0.019) were independent prognostic factors for survival. Conclusions Pretreatment NLR >2.43 ng/mL could serve as an indicator of poor prognosis in middle thoracic ESCC patients after surgical treatment.
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Affiliation(s)
- Jia Hu
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Dongni Chen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Shaoyong Wu
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Youfang Chen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Rongzhen Li
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Huikai Miao
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Zhesheng Wen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
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Li Y, Wu H, Xing C, Hu X, Zhang F, Peng Y, Li Z, Lu T. Prognostic evaluation of colorectal cancer using three new comprehensive indexes related to infection, anemia and coagulation derived from peripheral blood. J Cancer 2020; 11:3834-3845. [PMID: 32328188 PMCID: PMC7171501 DOI: 10.7150/jca.42409] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 03/27/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Many indicators of peripheral blood in routine blood test (BRT) results of colorectal cancer (CRC) patients are related to prognosis. Currently, indexes such as NLR (Neutrophil-to- Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio) and LMR (Lymphocyte-to-Monocyte ratio) evaluate the survival risk of patients by assessing the inflammatory - immune status of CRCs. These indexes are more comprehensive and accurate than independent estimates. We hope to design more effective indexes through fully considering the correlation and significance between BRT indicators and prognosis, so as to play a guiding role in clinical malignant estimation of CRCs. Methods: 701 CRCs in training set and 256 CRCs in test set were included in the study samples, and their clinical data, tumor pathology results and peripheral blood routine results were collected. The prognosis, progression, and survival status of all patients were determined after follow-up. Above data were used for statistical analysis and designing new indexes. Results: It was found that high NE, MONO, RDW-CV/SD and PLT in peripheral blood indicated poor prognosis of DFS and OS. Conversely, CRCs with postoperative tumor progression or death had lower LY, EO, RBC, HGB, HCT, MCV, MCH, MCHC, PDW, and P-LCR. IRR, ARR and CRR related to infection, anemia and coagulation were designed respectively using the largest AUC indicators (P<0.05) selected by ROC curve. The formula: IRR= (NE*MONO)/(LY*EO); ARR= (HGB*MCHC)/RDW-CV; CRR=PLT/PDW. Results of Kaplan‑Meier survival analysis and multivariate COX proportional hazard analysis adjusted for age, gender, TNM stage, infiltration, adhesion showed IRR, ARR, CRR were all able to be used as the evaluation standard of survival of CRC. The result was also authenticated in the test set. Conclusion: We designed three different prognostic indexes of colorectal cancer, IRR, ARR and CRR, which could be used as risk indicators of CRC prognosis, tumor progression and survival.
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Affiliation(s)
- Yalun Li
- Department of Anorectal Surgery, First Affiliated Hospital of China Medical University , Shenyang, Liaoning, China
| | - Huizhe Wu
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning, China
| | - Chengzhong Xing
- Department of Anorectal Surgery, First Affiliated Hospital of China Medical University , Shenyang, Liaoning, China
| | - Xiaoyun Hu
- Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning, China
| | - Fangxiao Zhang
- Department of Intensive Care Unit, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yangjie Peng
- Department of Anorectal Surgery, First Affiliated Hospital of China Medical University , Shenyang, Liaoning, China
| | - Zeyu Li
- Department of Anorectal Surgery, First Affiliated Hospital of China Medical University , Shenyang, Liaoning, China
| | - Tingting Lu
- Department of Anorectal Surgery, First Affiliated Hospital of China Medical University , Shenyang, Liaoning, China
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Öner K, Okutan AE, Ayas MS, Paksoy AE, Polat F. Predicting postoperative pain with neutrophil/ lymphocyte ratio after arthroscopic rotator cuff repair. ASIA-PACIFIC JOURNAL OF SPORT MEDICINE ARTHROSCOPY REHABILITATION AND TECHNOLOGY 2020; 20:24-27. [PMID: 32211297 PMCID: PMC7082212 DOI: 10.1016/j.asmart.2020.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 11/24/2019] [Accepted: 03/02/2020] [Indexed: 12/21/2022]
Abstract
Background Postoperative pain is well known and usually disturbing complication of arthroscopic shoulder surgery. Inflammation plays an important role in the development and progression of postoperative pain. The aim of this study was to evaluate the predictability of postoperative pain through the correlation of neutrophil/lymphocyte ratio (NLR) with inflammation. In addition, the correlation of parameters such as operative time, tear size, age and gender with postoperative pain was evaluated. Methods Sixty three patients, who underwent arthroscopic rotator cuff repair, were evaluated in this single-center-based retrospective study. The American Society of Anaesthesiologists I and II risk groups were determined as the inclusion criteria. NLR was calculated using preoperative one day hemogram values in all patients. The amounts of analgesic use and Numerical Rating Scale (NRS) scores at the 12th, 24th and 48th hours and on the 3rd and 7th days were recorded. Multivariate linear regression analysis was used to correlate postoperative NRS scores with multiple independent factors, including preoperative NLR, sex, age, tear size, repair type, operative time, block time, postoperative analgesic intake and length of hospital stay. Results Sixty three patients with a mean age of 59.4 years (range, 40-72 years) were evaluated. The mean tear size was 2.8 cm (range, 1-5 cm), the mean operative time was 84.1 min (range, 35-135 min), the mean duration of block was 7.6 hours (range, 4-12 hours) and the mean length of hospital stay was 1.7 days (range, 1-3 days). There was no significant correlation between age, sex, tear size, repair type, operative time and postoperative NRS (p > 0.2). The preoperative NLR was found to be a strong predictor of postoperative NRS (p < 0.001, rho = 0,864). There was a correlation between the NLR and mean analgesic intake (p = 0,03). The duration of block was decreased in patients with a NLR above 2, while it was prolonged in patients with a NLR below 2 (p = 0.04, rho = -0,725). Conclusion The preoperative NLR was found to be a strongest factor predicting high acute pain levels after arthroscopic rotator cuff surgery. Likewise, NLR was also predictive of postoperative block time and analgesic consumption.
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Affiliation(s)
- Kerim Öner
- Yozgat Bozok University, School of Medicine, Orthopaedics and Traumatology Dept., Yozgat, Turkey
| | - Ahmet Emin Okutan
- Karadeniz Technical University, School of Medicine, Orthopaedics and Traumatology Dept., Trabzon, Turkey
| | - Muhammet Salih Ayas
- Erzurum Regional Training and Research Hospital, Orthopaedics and Traumatology Dept., Erzurum, Turkey
| | - Ahmet Emre Paksoy
- Yozgat Bozok University, School of Medicine, Orthopaedics and Traumatology Dept., Yozgat, Turkey
| | - Ferdi Polat
- Sorgun State Hospital, Dept. of Anesthesiology, Yozgat, Turkey
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Szilasi Z, Jósa V, Zrubka Z, Mezei T, Vass T, Merkel K, Helfferich F, Baranyai Z. Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours-Results of a Retrospective Multicentric Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051742. [PMID: 32155982 PMCID: PMC7084240 DOI: 10.3390/ijerph17051742] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/27/2020] [Accepted: 03/03/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) may be useful for drawing conclusions about the survival of head and neck squamous cell carcinoma (HNSCC) patients. METHODS Clinical data of 156 patients managed for HNSCC at two head and neck surgery centres were analyzed retrospectively. We studied the relationships between survival and PLR as well as NLR. RESULTS With regards to 5-year survival, the difference between the two groups with PLR values lower or higher than the threshold was statistically significant (p = 0.004), and we found the same for disease-free survival (p = 0.05), and tumour-specific mortality (p = 0.009). Concerning NLR, the difference in tumour-specific survival was statistically significant (p = 0.006). According to the multivariate analysis, NLR values higher than the threshold indicated an enhanced risk for overall as well as for tumour-specific mortality. CONCLUSION In HNSCC patients, a high NLR may be considered as an independent risk factor for 5-year overall survival.
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Affiliation(s)
- Zsuzsanna Szilasi
- Department of Otorhinolaryngology and Head and Neck Surgery, HDF Medical Centre, H-1134 Budapest, Hungary;
- Correspondence: ; Tel.: +36-30-280-3053; Fax: +36-1-4752711
| | - Valéria Jósa
- Department of Otorhinolaryngology and Head and Neck Surgery, Jahn Ferenc Hospital, H-1204 Budapest, Hungary;
| | - Zsombor Zrubka
- Department of Health Economics, Corvinus University of Budapest, H-1093 Budapest, Hungary;
| | - Tünde Mezei
- Department of Urology, Jahn Ferenc Hospital, H-1204 Budapest, Hungary;
| | - Tamás Vass
- Department of Surgery, Szent Imre Hospital, H-1115 Budapest, Hungary; (T.V.); (K.M.)
| | - Keresztély Merkel
- Department of Surgery, Szent Imre Hospital, H-1115 Budapest, Hungary; (T.V.); (K.M.)
| | - Frigyes Helfferich
- Department of Otorhinolaryngology and Head and Neck Surgery, HDF Medical Centre, H-1134 Budapest, Hungary;
| | - Zsolt Baranyai
- 1st Department of Surgery, Semmelweis University, H-1082 Budapest, Hungary;
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Lao X, Ma L, Ma Q, Ma Q, Yang Z, Guo L, Nong W. Hematological factors associated with immunity, inflammation, and metabolism in patients with systemic lupus erythematosus: Data from a Zhuang cohort in Southwest China. J Clin Lab Anal 2020; 34:e23211. [PMID: 31978275 PMCID: PMC7307337 DOI: 10.1002/jcla.23211] [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: 11/11/2019] [Revised: 12/19/2019] [Accepted: 12/26/2019] [Indexed: 01/01/2023] Open
Abstract
Introduction Hematological parameters play important role in multiple diseases. This study was to investigate the possible association of the routine hematological parameters involved in immunity, inflammation, and metabolism with systemic lupus erythematosus (SLE) in patients of Zhuang ethnicity in Guangxi, southwest China. Methods The medical records of 195 Zhuang SLE patients between January 2013 and November 2018 were retrospectively reviewed. Random forest algorithm and multivariate logistic regression were used to identify the feature hematological parameters in patients with SLE. Association rules were explored between each parameter and immunity‐ (IgG, IgA, IgM, C3, and C4), inflammation‐ (ESR, hs‐CRP, and CAR), and metabolism‐ (TG, TC, HDL‐C, LDL‐C, TP, PA, ALB, and UA) related indexes. Results Random forest algorithm and logistic regression analysis showed that neutrophil‐to‐lymphocyte ratio (NLR), red blood cell distribution width (RDW), and platelet‐to‐lymphocyte ratio (PLR) were the feature parameters for distinguishing SLE patients from healthy controls. According to the ROC curves, the optimal cutoff values to predict SLE were 1.98 for NLR, 13.35 for RDW, and 145.64 for PLR. Association rule analysis showed that NLR was strongly associated with C3, hs‐CRP, TG, ALB, and UA; RDW was strongly associated with C3, C4, hs‐CRP, TG, and ALB; PLR was strongly associated with IgG, hs‐CRP, HDL‐C, and UA. Conclusions Neutrophil‐to‐lymphocyte ratio, RDW, and PLR may serve as effective predictors of dysregulation in immunity, inflammation, and metabolism. These three indicators may be potential for cardiovascular risk assessment in Zhuang SLE patients in southwest China.
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Affiliation(s)
- Xiaoxia Lao
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Liping Ma
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Qingwei Ma
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Qiaorong Ma
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Zhige Yang
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Lingxiao Guo
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Wenzheng Nong
- Department of Gynaecology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
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Tustumi F, Takeda FR, Viyuela MS, da Cruz Junior JB, Brandão AAGS, Sallum RAA, Ribeiro Junior U, Cecconello I. The value of cellular components of blood in the setting of trimodal therapy for esophageal cancer. J Surg Oncol 2019; 121:784-794. [PMID: 31762058 DOI: 10.1002/jso.25778] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 11/11/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inflammation status plays an important role in the natural history of malignancy. Consequently, hematological markers of systemic inflammation may predict prognosis in neoplasms. This study evaluated the value of cellular blood components changes during neoadjuvant chemoradiotherapy followed by esophagectomy for cancer in predicting prognosis. METHODS A cohort of 149 patients was analyzed. Cellular components of blood were assessed before neoadjuvant therapy (A); before surgery (B); and 3 to 5 months after surgery (C); for the following outcomes: pathological response, overall survival (OS), and disease-free survival (DFS). Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of blood count variables. RESULTS Low hematocrit (Ht) (C) (HR, 0.85; 95% CI, 0.79-0.92) and high neutrophil-to-lymphocyte ratio (NLR) (C) (HR, 1.07; 95% CI, 1.07-1.10) were related to poor OS. Low Hb (C) (HR, 0.72; 95% CI, 0.58-0.88), red cell distribution width (RDW) (C-A) (HR, 1.16; 95% CI, 1.02-1.31), and NLR (C-A) (1.06; 95% CI, 1.03-1.09) were related to poor DFS. RDW (B-A) (HR, 1.15; 95% CI, 1.08-1.22), RDW (C) (HR, 1.12; 95% CI, 1.04-1.2), NLR (C) (HR, 1.12; 95% CI, 1.08-1.17) were related to systemic recurrence. CONCLUSION Variables of routine blood count are easily assessable and their changes throughout trimodal therapy for esophageal carcinoma provide important information for cancer patient's prognosis.
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Affiliation(s)
- Francisco Tustumi
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
| | - Flávio Roberto Takeda
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
| | - Mateus Silva Viyuela
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Ulysses Ribeiro Junior
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
| | - Ivan Cecconello
- Department of Gastroenterology, Digestive Surgery Division, Univerresity of São Paulo, São Paulo, SP, Brazil
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Miao Y, Zhou XH, Guo JJ, Sun Q, Shi K, Wu JZ, Zhu HY, Wang L, Fan L, Xu W, Li JY. Association of red blood cell distribution width and outcomes in patients with mantle cell lymphoma. Cancer Med 2019; 8:2751-2758. [PMID: 30980510 PMCID: PMC6558583 DOI: 10.1002/cam4.2155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/19/2019] [Accepted: 03/26/2019] [Indexed: 12/11/2022] Open
Abstract
Red blood cell distribution width (RDW), which measures the range of variation of red blood cell volume, has been explored as a prognostic factor in multiple types of cancer. However, the role of RDW in mantle cell lymphoma (MCL), a rare type of non-Hodgkin lymphoma with poor outcomes, remains to be determined. Therefore, we investigated the prognostic role of RDW in MCL. We found that 21 of 76 MCL patients (27.6%) had an abnormally elevated RDW (>15.7%). Abnormally elevated RDW was significantly associated with presence of B symptoms (P = 0.0020), elevated lactate dehydrogenase (LDH) (P = 0.0010), higher leukocyte count (P = 0.0345), higher simplified Mantle Cell International Prognostic Index (sMIPI) (P = 0.0194), and lower level of hemoglobin (Hb) (P < 0.0001). It was marginally associated with increased C-reactive protein (P = 0.0862). RDW was significantly correlated with Hb level (r2 = 0.42) and LDH level (r2 = 0.19). 15.8% was determined as the best cutoff of RDW in predicting the survival outcome by the X-tile software. Survival analysis revealed that high RDW (>15.8%) predicted shorter progression-free survival (PFS) (hazards ratio [HR]: 3.14; P = 0.0005) and shorter overall survival (OS) (HR: 4.04; P < 0.0001). High RDW independently predicted both shorter PFS (P = 0.0493) and OS (P = 0.0118). RDW also improved the prognostic stratification based on sMIPI. In conclusion, our study identified RDW as a novel prognostic factor of clinical feasibility in the prognostication of MCL.
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Affiliation(s)
- Yi Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Xiao-Hui Zhou
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Jing-Jing Guo
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Qian Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Ke Shi
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Jia-Zhu Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Hua-Yuan Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Li Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Lei Fan
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Wei Xu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
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