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Wang S, Liu M, Xiang L, Qiu H, Cheng L, Huang Z, Wen T, Xie W, Li S, Zhang C, Wang G, Li H, Li D. Tumour burden score combined with albumin-to-alkaline phosphatase ratio predicts prognosis in patients with intrahepatic cholangiocarcinoma. J Cell Mol Med 2024; 28:e18530. [PMID: 38961673 PMCID: PMC11222657 DOI: 10.1111/jcmm.18530] [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: 05/03/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024] Open
Abstract
Tumour morphology (tumour burden score (TBS)) and liver function (albumin-to-alkaline phosphatase ratio (AAPR)) have been shown to correlate with outcomes in intrahepatic cholangiocarcinoma (ICC). This study aimed to evaluate the combined predictive effect of TBS and AAPR on survival outcomes in ICC patients. We conducted a retrospective analysis using a multicentre database of ICC patients who underwent curative surgery from 2011 to 2018. The Kaplan-Meier method was employed to examine the relationship between a new index (combining TBS and AAPR) and long-term outcomes. The predictive efficacy of this index was compared to other conventional indicators. A total of 560 patients were included in the study. Based on TBS and AAPR stratification, patients were classified into three groups. Kaplan-Meier curves demonstrated that 124 patients with low TBS and high AAPR had the best overall survival (OS) and recurrence-free survival (RFS), while 170 patients with high TBS and low AAPR had the worst outcomes (log-rank p < 0.001). Multivariate analyses identified the combined index as an independent predictor of OS and RFS. Furthermore, the index showed superior accuracy in predicting OS and RFS compared to other conventional indicators. Collectively, this study demonstrated that the combination of liver function and tumour morphology provides a synergistic effect in evaluating the prognosis of ICC patients. The novel index combining TBS and AAPR effectively stratified postoperative survival outcomes in ICC patients undergoing curative resection.
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Affiliation(s)
- Sheng Wang
- School of Medicine, Chongqing UniversityChongqing University Cancer HospitalChongqingChina
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Maoyun Liu
- School of Medicine, Chongqing UniversityChongqing University Cancer HospitalChongqingChina
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Lei Xiang
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Haizhou Qiu
- Department of Liver Surgery, West China HospitalSichuan UniversityChengduChina
| | - Luo Cheng
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Zuotian Huang
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Tao Wen
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Wenyuan Xie
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Sipeng Li
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Cheng Zhang
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Genshu Wang
- Department of Liver Transplantation, State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Hui Li
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
| | - Dewei Li
- School of Medicine, Chongqing UniversityChongqing University Cancer HospitalChongqingChina
- Department of Hepatobiliary Pancreatic Tumor CenterChongqing University Cancer HospitalChongqingChina
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Ren S, Xv C, Wang D, Xiao Y, Yu P, Tang D, Yang J, Meng X, Zhang T, Zhang Y, He Q, Li Q, Gallagher M, Feng Y. The predictive value of systemic immune-inflammation index for vascular access survival in chronic hemodialysis patients. Front Immunol 2024; 15:1382970. [PMID: 38827733 PMCID: PMC11140091 DOI: 10.3389/fimmu.2024.1382970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/02/2024] [Indexed: 06/04/2024] Open
Abstract
Objective To examine the prognostic values of systemic immune-inflammation indices of hemodialysis (HD) vascular access failure and develop a prediction model for vascular access failure based on the most pertinent systemic immune-inflammation index. Study design A prospective cohort study. Setting & participants Patients undergoing autogenous HD vascular access surgeries or arteriovenous graft as a permanent hemodialysis access in a tertiary center in southwest China from January 2020 to June 2022. Predictors Systemic immune-inflammation indices, including NLR, dNLR, AAPR, SIRI, SII, PNI, PLR, and LIPI, and clinical variables. Outcomes The outcome was defined as survival of the hemodialysis access, with both occluded and stenotic access being considered as instances of access failure. Analytical approach Cox proportional hazard regression model. Results 2690 patients were included in the study population, of whom 658 experienced access failure during the follow-up period. The median duration of survival for HD vascular access was 18 months. The increased systemic immune-inflammation indices, including dNLR, NLR, SII, PNI, SIRI, PLR, and LIPI, are predictive of HD access failure, with SII demonstrating the strongest prognostic value. A simple SII-based prediction model for HD access failure was developed, achieving C-indexes of 0.6314 (95% CI: 0.6249 - 0.6589) and 0.6441 (95% CI: 0.6212 - 0.6670) for predicting 6- and 12-month access survival, respectively. Conclusions Systemic immune-inflammation indices are significantly and negatively associated with HD vascular access survival. A simple SII-based prediction model was developed and anticipates further improvement through larger study cohort and validation from diverse centers.
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Affiliation(s)
- Song Ren
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Chuan Xv
- Medical Information Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Dongqing Wang
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
- Nephropathy and Rheumatology, Medical Center Hospital of QiongLai City, Qionglai, China
| | - Yan Xiao
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Panpan Yu
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Deying Tang
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Juan Yang
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Xianglong Meng
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Tao Zhang
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Yaling Zhang
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Qiang He
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
| | - Quiang Li
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Martin Gallagher
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Yunlin Feng
- Department of Nephrology and Institute of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, China
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
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Yang Y, Wang Y, Li X, Xie X. Clinical role of pretreatment albumin-to-alkaline phosphatase ratio in lung cancer: a meta-analysis. Sci Rep 2024; 14:1166. [PMID: 38216656 PMCID: PMC10786841 DOI: 10.1038/s41598-024-51844-8] [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: 08/31/2023] [Accepted: 01/10/2024] [Indexed: 01/14/2024] Open
Abstract
The association between pretreatment albumin-to-alkaline phosphatase ratio (AAPR) and clinicopathological parameters and prognosis in lung cancer is unclear. The study aimed to identify the clinical role of pretreatment AAPR among lung cancer patients. Several databases were searched for relevant studies. The primary outcome and secondary outcome were long-term survival including the overall survival (OS) and progression-free survival (PFS) and clinicopathological characteristics, respectively. The hazard ratios (HRs) and relative risks (RRs) with 95% confidence intervals (CIs) were combined. A total of 11 publications involving 10,589 participants were included in this meta-analysis. The pooled results manifested that a lower pretreatment AAPR predicted poorer OS (HR = 0.65, 95% CI 0.59-0.71, P < 0.001) and PFS (HR = 0.68, 95% CI 0.59-0.78, P < 0.001). Furthermore, subgroup analysis for the OS and PFS based on the pathological type and treatment showed similar results and pretreatment AAPR was significantly associated with worse prognosis. Besides, pretreatment AAPR was significantly associated with male (RR = 1.08, 95% CI 1.03-1.13, P < 0.001), poor differentiation (RR = 1.33, 95% CI 1.03-1.73, P = 0.029), advanced T stage (RR = 1.25, 95% CI 1.03-1.52, P = 0.026), N stage (RR = 1.34, 95% CI 1.15-1.55, P < 0.001) and TNM stage (RR = 1.14, 95% CI 1.06-1.223, P < 0.001). Therefore, pretreatment AAPR is significantly related to prognosis and tumor stage in lung cancer and patients with a lower pretreatment AAPR are more likely to experience poor survival and advanced tumor stage.
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Affiliation(s)
- Yanhui Yang
- Department of Cardiothoracic Surgery, The First People's Hospital of Neijiang, Neijiang, Sichuan, China
| | - Yi Wang
- Department of Cardiothoracic Surgery, The First People's Hospital of Neijiang, Neijiang, Sichuan, China
| | - Xiaoliang Li
- Department of Cardiothoracic Surgery, The First People's Hospital of Neijiang, Neijiang, Sichuan, China
| | - Xiaoyang Xie
- Department of Cardiothoracic Surgery, The First People's Hospital of Neijiang, Neijiang, Sichuan, China.
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Ren S, Wang H, Yang B, Zheng Y, Ou Y, Bao Y, Mao Y, Feng Y. Prognostic value of preoperative albumin-to-alkaline phosphatase ratio in patients with surgically treated urological cancer: a systematic review and meta-analysis. Front Oncol 2023; 13:1236167. [PMID: 38023164 PMCID: PMC10666183 DOI: 10.3389/fonc.2023.1236167] [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: 08/09/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Objective A novel albumin-to-alkaline phosphatase ratio (AAPR) is associated with the prognosis of several cancers. In the present study, we evaluate the prognostic significance of perioperative AAPR in urological cancers. Method Relevant studies were searched comprehensively from CNKI, PubMed, Embase and Web of Science up to March 2023. The pooled hazard ratio (HR) and 95% confidence interval (CI) were extracted from each study to evaluate the prognostic value of perioperative AAPR in patients with surgically treated urological cancers. Results A total of 8 studies consisting of 3,271 patients were included in the final results. A low AAPR was significantly associated with a worse OS (HR=2.21; P<0.001), CSS (HR=2.61; P<0.001) and RFS/DFS (HR=2.87; P=0.001). Stratified by disease, a low AAPR was also associated with worse OS in renal cell carcinoma (HR=2.01; P<0.001), bladder cancer (HR=3.37; P<0.001) and upper tract urothelial carcinoma (HR=1.59; P=0.002). Conclusion In conclusion, low AAPR could serve as an unfavorable factor in patients with surgically treated urological cancers. Stratified by tumor type, the low AAPR was also associated with inferior survival. While more prospective and large-scale studies are warranted to validate our findings.
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Affiliation(s)
- Shangqing Ren
- Robotic Minimally Invasive Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China
| | - Han Wang
- Department of Gastroenterology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
| | - Bo Yang
- Department of Pediatric Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
| | - Yang Zheng
- Robotic Minimally Invasive Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yong Ou
- Robotic Minimally Invasive Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yige Bao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Mao
- Department of Pediatric Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
| | - Yunlin Feng
- Department of Nephrology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Gradel KO. Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review. J Clin Med 2023; 12:6132. [PMID: 37834777 PMCID: PMC10573484 DOI: 10.3390/jcm12196132] [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: 07/07/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
This review assesses how publications interpret factors that influence the serum or plasma albumin (PA) level in prognostic indices, focusing on inflammation and nutrition. On PubMed, a search for "albumin AND prognosis" yielded 23,919 results. From these records, prognostic indices were retrieved, and their names were used as search strings on PubMed. Indices found in 10 or more original research articles were included. The same search strings, restricted to "Review" or "Systematic review", retrieved yielded on the indices. The data comprised the 10 latest original research articles and up to 10 of the latest reviews. Thirty indices had 294 original research articles (6 covering two indices) and 131 reviews, most of which were from recent years. A total of 106 articles related the PA level to inflammation, and 136 related the PA level to nutrition. For the reviews, the equivalent numbers were 54 and 65. In conclusion, more publications mention the PA level as a marker of nutrition rather than inflammation. This is in contrast to several general reviews on albumin and nutritional guidelines, which state that the PA level is a marker of inflammation but not nutrition. Hypoalbuminemia should prompt clinicians to focus on the inflammatory aspects in their patients.
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Affiliation(s)
- Kim Oren Gradel
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark; ; Tel.: +45-21-15-80-85
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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