1
|
Dojcinovic T, Tomsic KZ, Vodanovic ID, Dusek T, Kraljevic I, Nekic AB, Polovina TS, Knezevic N, Alduk AM, Golubic ZA, Kastelan D. Treatment Outcomes in Patients with Recurrent Adrenocortical Carcinoma. Endocr Res 2024:1-7. [PMID: 39221851 DOI: 10.1080/07435800.2024.2397561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/17/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND While numerous studies have explored treatment outcomes for the overall ACC patient cohort, data on the subpopulation of patients with recurrent disease are limited. Therefore, the aim of this study was to assess treatment outcomes in patients with recurrent ACC. METHODS In this retrospective study, we included 18 patients median age 49 years (42-62); 67% female) diagnosed with recurrent ENSAT stage I-III ACC who underwent either R0 (n = 16) or Rx (n = 2) surgical resection of the tumor. RESULTS The median time from the initial surgery to ACC recurrence was 29 months (IQR 18-50). Seven patients (39%) manifested local recurrence, while 11 patients (61%) developed distant metastases. The median follow-up duration after tumor recurrence was 32 months (IQR 25-53). Regarding the treatment of ACC recurrence, 10 patients underwent a second surgery either as an alone procedure (n = 4), or in combination with mitotane (n = 4), mitotane and chemotherapy (n = 1), or mitotane combined with radiotherapy (n = 1). The remaining patients received treatment involving chemotherapy±mitotane (n = 4) and locoregional therapy ±chemotherapy (n = 3). One patient chose not to proceed with further management and follow-up. The median PFS was 17 (95% CI 8-26) months while the median OS was not reached. In the multivariate model, increased mortality was associated with advanced age (p = 0.04) and a shorter interval to ACC recurrence (p = 0.03). CONCLUSION A significant proportion of patients with ACC recurrence experience disease progression or second recurrence, despite all treatment efforts. Nevertheless, by integrating diverse treatment modalities, many patients have the potential to attain long-term survival.
Collapse
Affiliation(s)
- Tamara Dojcinovic
- Department of Endocrinology of the Internal medicine clinic, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
- School of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Karin Zibar Tomsic
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
| | | | - Tina Dusek
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivana Kraljevic
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Anja Barac Nekic
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
| | | | - Nikola Knezevic
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Urology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ana Marija Alduk
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Darko Kastelan
- Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
2
|
Mangone A, Favero V, Prete A, Elhassan YS, Asia M, Hardy R, Mantovani G, Chiodini I, Ronchi CL. Inflammation-based scores in a large cohort of adrenocortical carcinoma and adrenocortical adenoma: role of the hormonal secretion pattern. J Endocrinol Invest 2024:10.1007/s40618-024-02426-y. [PMID: 38965182 DOI: 10.1007/s40618-024-02426-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/26/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Serum inflammation-based scores can predict clinical outcome in several cancer types, including adrenocortical carcinoma (ACC). It is unclear whether the extent of inflammation-based scores alterations in ACC reflects malignancy, steroid excess, or both. METHODS We investigated a large retrospective cohort of adrenocortical adenomas (ACA, n = 429) and ACC (n = 61) with available baseline full blood count and hormonal evaluation. We examined the relationship between different inflammation-based scores [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), and prognostic nutrition index (PNI)] and both malignancy and steroid secretion patterns. RESULTS All inflammation-based scores differed between ACC and ACA: patients with ACC had higher NLR, PLR, SII and lower LMR and PNI levels compared to ACA (all p values < 0.001). NLR showed a positive correlation with cortisol levels after overnight 1 mg-dexamethasone suppression test (1 mg-DST), both in ACC and ACA (p < 0.01). The ROC curve analysis determined NLR > 2.6 as the best cut-off to discriminate ACC from ACA [AUC = 0.846, p < 0.01]. At multivariable analysis, NLR > 2.6 was independently associated with ACC, 1 mg-DST cortisol levels and age, but not with tumour size. Considering the ACC, NLR and SII were higher and PNI was lower in patients with cortisol excess compared to those without cortisol excess (p = 0.002, p = 0.007, and p = 0.044 respectively). Finally, LMR and NLR differed between inactive-ACC (n = 10) and inactive-ACA (n = 215) (p = 0.040 and p = 0.031, respectively). CONCLUSION Inflammation-based scores are related to steroid secretion both in ACC and ACA. ACCs present a higher grade of inflammation regardless of their hormonal secretion, likely as a feature of malignancy itself.
Collapse
Affiliation(s)
- A Mangone
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - V Favero
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Endocrinology Unit, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - A Prete
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, B152TT, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Y S Elhassan
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, B152TT, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Asia
- Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - R Hardy
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, B152TT, UK
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - G Mantovani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - I Chiodini
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Endocrinology Unit, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - C L Ronchi
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, B152TT, UK.
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.
- Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| |
Collapse
|
3
|
Ma C, Yang B, Mao Q. Diagnostic and Prognostic Value of Neutrophil-Lymphocyte Ratio in Adrenocortical Carcinoma. Clin Genitourin Cancer 2024; 22:109-114. [PMID: 37852864 DOI: 10.1016/j.clgc.2023.09.008] [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: 09/23/2022] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The aim was to explore the value of neutrophil-lymphocyte ratio (NLR) as a biomarker for predicting the prognosis or diagnosis in adrenocortical carcinoma (ACC). METHODS We identified 262 patients with adrenal gland disease who underwent operation at our institution between 2013 and 2018. According to postoperative pathology, patients were divided into 2 groups: ACC and non-ACC groups. The neutrophil and lymphocyte count of patients were recorded. Within the intergroup comparison, data obtained from ACC and non-ACC groups were evaluated using ANOVA test. The cut-off values of NLR for the prognosis in ACC were determined according to 3 methods. RESULTS The NLR values of ACC and non-ACC groups were 5.36 ± 5.30 and (1.73 ± 0.26) ∼ (2.56 ± 1.35), respectively (P < .001). NLR carry a differential property was evaluated with ROC curve to distinguish the above 2 groups. The cut-off value of NLR was estimated as 2.65 according to the Youden index. With this value, sensitivity was found as 67.5%, specificity was 83.8% and AUC was 0.749 (P < .001, confidence interval = 0.638-0.860). In ACC, the higher NLR group was not shown significantly poorer overall survival than the lower NLR group (NLR ≥2.65 vs. NLR < 2.65, NLR ≥5 vs. NLR <5, NLR ≥5.36 vs. NLR <5.36) (P > .05). CONCLUSION According to the data in this study, it can be said that adrenocortical tumors are likely to be malignant by 67.5% if the NLR value is greater than 2.65. When we use the NLR to predict the prognosis of ACC, there is not statistically significant.
Collapse
Affiliation(s)
- Chengquan Ma
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.
| | - Bin Yang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Quanzong Mao
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
4
|
Vukomanovic V, Nedic KV, Radojevic MZ, Dagovic A, Milosavljevic N, Markovic M, Ignjatovic V, Simic Vukomanovic I, Djukic S, Sreckovic M, Backovic M, Vuleta M, Djukic A, Vukicevic V, Ignjatovic V. Predicting the survival probability of functional neuroendocrine tumors treated with peptide receptor radionuclide therapy: Serbian experience. Front Endocrinol (Lausanne) 2024; 14:1270421. [PMID: 38317712 PMCID: PMC10840135 DOI: 10.3389/fendo.2023.1270421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024] Open
Abstract
Introduction Peptide receptor radionuclide therapy (PRRT) is a treatment option for well-differentiated, somatostatin receptor positive, unresectable or/and metastatic neuroendocrine tumors (NETs). Although high disease control rates seen with PRRT a significant number NET patients have a short progression-free interval, and currently, there is a deficiency of effective biomarkers to pre-identify these patients. This study is aimed at determining the prognostic significance of biomarkers on survival of patients with NETs in initial PRRT treatment. Methodology We retrospectively analyzed 51 patients with NETs treated with PRRT at the Department for nuclear medicine, University Clinical Center Kragujevac, Serbia, with a five-year follow-up. Eligible patients with confirmed inoperable NETs, were retrospectively evaluated hematological, blood-based inflammatory markers, biochemical markers and clinical characteristics on disease progression. In accordance with the progression og the disease, the patients were divided into two groups: progression group (n=18) and a non-progression group (n=33). Clinical data were compared between the two groups. Results A total of 51 patients (Md=60, age 25-75 years) were treated with PRRT, of whom 29 (56.86%) demonstrated stable disease, 4 (7.84%) demonstrated a partial response, and 14 (27.46%) demonstrated progressive disease and death was recorded in 4 (7.84%) patients. The mean PFS was a 36.22 months (95% CI 30.14-42.29) and the mean OS was 44.68 months (95% CI 37.40-51.97). Univariate logistic regression analysis displayed that age (p<0.05), functional tumors (p<0.05), absolute neutrophil count (p<0.05), neutrophil-lymphocyte ratio-NLR (p<0.05), C-reactive protein-CRP (p<0.05), CRP/Albumin (p<0.05), alanine aminotransferase-ALT (p<0.05), were risk factors for disease progression. Multivariate logistic regression analysis exhibited that functional tumors (p<0.001), age (p<0.05), CRP (p<0.05), and ALT (p<0.05), were independent risk factors for the disease progression in patients with NETs. Tumor functionality was the most powerful prognostic factor. The median PFS (11.86 ± 1.41 vs. 43.38 ± 3.16 months; p=0.001) and OS (21.81 ± 2.70 vs 53.86 ± 3.70, p=0.001) were significantly shorter in patients with functional than non-functional NETs respectively. Conclusion The study's results suggest that tumor functionality, and certain biomarkers may serve as prognostic survival indicators for patients with NETs undergoing PRRT. The findings can potentially help to identify patients who are at higher risk of disease progression and tailor treatment strategies accordingly.
Collapse
Affiliation(s)
- Vladimir Vukomanovic
- Department of Nuclear Medicine and Clinical Oncology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department for Nuclear Medicine, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Katarina Vuleta Nedic
- Department of Nuclear Medicine and Clinical Oncology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department for Nuclear Medicine, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Marija Zivkovic Radojevic
- Department of Nuclear Medicine and Clinical Oncology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department for Radiotherapy, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Aleksandar Dagovic
- Department of Nuclear Medicine and Clinical Oncology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department for Medical Oncology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Neda Milosavljevic
- Department of Nuclear Medicine and Clinical Oncology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department for Radiotherapy, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Marina Markovic
- Department for Medical Oncology, University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Vladimir Ignjatovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Clinic for Cardiology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Ivana Simic Vukomanovic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department of Health Promotion, Institute of Public Health, Kragujevac, Serbia
| | - Svetlana Djukic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Clinic for Hematology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Marijana Sreckovic
- Department of Medical and Business-Technological, Academy of Professional Studies Sabac, Sabac, Serbia
| | - Milena Backovic
- Department for Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko Vuleta
- Department for Cardiology, Clinical Hospital Center “Dr Dragisa Misovic Dedinje”, Belgrade, Serbia
| | - Aleksandar Djukic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center Kragujevac, Kragujevac, Serbia
| | | | - Vesna Ignjatovic
- Department of Nuclear Medicine and Clinical Oncology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department for Nuclear Medicine, University Clinical Center Kragujevac, Kragujevac, Serbia
| |
Collapse
|
5
|
Wu W, Zhang D, Jin T, Lu T, Zhou F. Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy. Front Immunol 2023; 14:1142346. [PMID: 37063849 PMCID: PMC10097887 DOI: 10.3389/fimmu.2023.1142346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/22/2023] [Indexed: 04/01/2023] Open
Abstract
Urolithiasis is a common and frequent disease in urology. Percutaneous nephrolithotomy (PCNL) is preferred for the treatment of upper urinary tract stones and complicated renal stones >2 cm in diameter, but it has a higher rate of postoperative complications, especially infection, compared with other minimally invasive treatments for urinary stones. Complications associated with infection after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome (SIRS), and sepsis, which is considered one of the most common causes of perioperative death after percutaneous nephrolithotomy. In contrast, SIRS serves as a sentinel for sepsis, so early intervention of SIRS by biomarker identification can reduce the incidence of postoperative sepsis, which in turn reduces the length of stay and hospital costs for patients. In this paper, we summarize traditional inflammatory indicators, novel inflammatory indicators, composite inflammatory indicators and other biomarkers for early identification of systemic inflammatory response syndrome after percutaneous nephrolithotomy.
Collapse
Affiliation(s)
- Wangjian Wu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Di Zhang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
| | - Tongtong Jin
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Tianyi Lu
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
| | - Fenghai Zhou
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- Department of Urology, Gansu Provincial Hospital, Lanzhou, China
- *Correspondence: Fenghai Zhou,
| |
Collapse
|
6
|
Utility of Serum Ki-67 as a Marker for Malignancy in Dogs. Animals (Basel) 2022; 12:ani12101263. [PMID: 35625109 PMCID: PMC9138135 DOI: 10.3390/ani12101263] [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: 04/09/2022] [Revised: 05/08/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Although serum tumour markers offer an uncomplicated, non-invasive examination method and possible therapeutic options, they are still rarely used in veterinary medicine. Our marker of interest, the Ki-67 protein, can only be detected in the active phases of the cell cycle. Therefore, it is a suitable marker for assessing the proliferating cell fraction of an organism and can thus provide information about potentially present, rapid-growing tumour tissue. The purpose of our study was to determine whether Ki-67 could be considered as a possible tumour marker in canine serum for veterinary medicine. We measured serum concentrations of Ki-67 in dogs with various malignant tumours, such as carcinomas, sarcomas, and lymphomas. In the dogs with malignant tumours we determined significantly higher serum Ki-67 concentrations compared with healthy dogs and dogs with non-malignant diseases. No significant difference in serum Ki-67 concentration was observed between the different types of cancer or between benign and malignant mammary tumours. Our investigations also included some inflammatory parameters measured in blood, such as neutrophils, lymphocytes, and monocytes, with mixed results. The results of our study suggest that Ki-67 may be useful as a potential serum tumour marker, providing information about the presence of malignant diseases in a dog. Abstract Tumour markers are scarcely used in veterinary medicine, although they are non-invasive, contribute to a faster diagnosis and new therapeutic options. The nuclear protein Ki-67 is absent in G0-phase but is detectable throughout all active phases of the cell cycle. Consequently, it is used as a marker for the proliferating cell fraction of a cell population and thus could indicate neoplastic tissue present. Our study is designed to show whether Ki-67 can be considered as a potential canine serum tumour marker for veterinary medicine. We measured serum concentrations of Ki-67 in dogs with various malignant tumours (carcinomas (n = 35); sarcomas (n = 26); lymphomas (n = 21)) using a commercially available quantitative sandwich ELISA from mybiosource. Dogs with malignant tumours showed significantly higher serum Ki-67 concentrations compared to healthy dogs (n = 19) and non-neoplastic diseased dogs (n = 26). No significant difference in serum Ki-67 concentration was detected between carcinoma, sarcoma, and lymphoma, nor between mammary adenocarcinoma and adenoma. In our investigations we also included some inflammatory parameters measured in blood, such as neutrophils, lymphocytes, and monocytes, and gained mixed results. The results of our study suggest that Ki-67 may be useful as a potential serum tumour marker, providing information about the presence of malignancies in a dog.
Collapse
|
7
|
Barac Nekic A, Knezevic N, Zibar Tomsic K, Kraljevic I, Balasko A, Skoric Polovina T, Solak M, Dusek T, Kastelan D. The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma. J Pers Med 2022; 12:jpm12010100. [PMID: 35055415 PMCID: PMC8780290 DOI: 10.3390/jpm12010100] [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: 11/22/2021] [Revised: 12/21/2021] [Accepted: 01/07/2022] [Indexed: 11/16/2022] Open
Abstract
Complete surgical removal of adrenocortical carcinoma (ACC) represents the only chance of long-term cure. In this study, we compared the long-term outcomes of ACC patients depending on whether they had adrenal surgery performed in a high-volume (HVC) or in a low-volume (LVC) center. This retrospective study included 49 patients from the Croatian ACC Registry with the European Network for the Study of Adrenal Tumors (ENSAT) stage I–III ACC, of which 35 underwent surgery in a HVC whereas 14 of them were operated in one of the LVCs. Patients operated in the LVCs had a significantly higher rate of ACC recurrence (57.1% vs. 22.9%; p = 0.02). Accordingly, RFS was significantly longer in patients operated on in HVC (p = 0.04). The difference in RFS remained significant after controlling for age, gender, tumor size, Ki-67 index, Weiss score, and type of surgery (HR 4.55; 95% CI 1.16–17.88; p = 0.03). In addition, there is a tendency towards longer DSS in patients in the HVC group compared to those in the LVC group (p = 0.05). These results point to the centralization of adrenal surgery as a key prerequisite for improving the outcomes of ACC patients.
Collapse
Affiliation(s)
- Anja Barac Nekic
- Department of Internal Medicine, General Hospital Dubrovnik, Roka Misetica 2, 20000 Dubrovnik, Croatia
- Correspondence:
| | - Nikola Knezevic
- Department of Urology, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, Salata 2, 10000 Zagreb, Croatia; (I.K.); (T.D.); (D.K.)
| | - Karin Zibar Tomsic
- Department of Endocrinology, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; (K.Z.T.); (A.B.); (T.S.P.); (M.S.)
| | - Ivana Kraljevic
- School of Medicine, University of Zagreb, Salata 2, 10000 Zagreb, Croatia; (I.K.); (T.D.); (D.K.)
- Department of Endocrinology, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; (K.Z.T.); (A.B.); (T.S.P.); (M.S.)
| | - Annemarie Balasko
- Department of Endocrinology, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; (K.Z.T.); (A.B.); (T.S.P.); (M.S.)
| | - Tanja Skoric Polovina
- Department of Endocrinology, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; (K.Z.T.); (A.B.); (T.S.P.); (M.S.)
| | - Mirsala Solak
- Department of Endocrinology, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; (K.Z.T.); (A.B.); (T.S.P.); (M.S.)
| | - Tina Dusek
- School of Medicine, University of Zagreb, Salata 2, 10000 Zagreb, Croatia; (I.K.); (T.D.); (D.K.)
- Department of Endocrinology, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; (K.Z.T.); (A.B.); (T.S.P.); (M.S.)
| | - Darko Kastelan
- School of Medicine, University of Zagreb, Salata 2, 10000 Zagreb, Croatia; (I.K.); (T.D.); (D.K.)
- Department of Endocrinology, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia; (K.Z.T.); (A.B.); (T.S.P.); (M.S.)
| | | |
Collapse
|
8
|
Wang P, Guo X, Zhou Y, Li Z, Yu S, Sun Y, Hua Y. Monocyte-to-high-density lipoprotein ratio and systemic inflammation response index are associated with the risk of metabolic disorders and cardiovascular diseases in general rural population. Front Endocrinol (Lausanne) 2022; 13:944991. [PMID: 36157453 PMCID: PMC9500229 DOI: 10.3389/fendo.2022.944991] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The present study aimed to clarify the effects of four inflammatory indicators (monocyte-to-high-density lipoprotein ratio [MHR], neutrophil-to-lymphocyte ratio [NLR], systematic immune-inflammation index [SII], and systemic inflammation response index [SIRI]) in evaluating the risk of metabolic diseases and cardiovascular disease (CVD), filling the gap of inflammation-metabolism system research in epidemiology. METHODS We conducted a cross-sectional study and multivariable logistic regression analysis to elucidate the association between inflammatory indicators and metabolic diseases and CVD risk. Metabolic diseases were defined as metabolic disorders (MetDs) or their components, such as metabolic syndrome (MetS), dyslipidemia, and central obesity. We calculated the Framingham risk score (FRS) to evaluate 10-year CVD risk. RESULTS Odds ratios for the third vs. the first tertile of MHR were 2.653 (95% confidence interval [CI], 2.142-3.286) for MetD, 2.091 (95% CI, 1.620-2.698) for MetS, 1.547 (95% CI, 1.287-1.859) for dyslipidemia, and 1.515 (95% CI, 1.389-1.652) for central obesity. Odds ratios for the third vs. the first tertile of SIRI were 2.092 (95% CI, 1.622-2.699) for MetD, 3.441 (95% CI, 2.917-4.058) for MetS, 1.417 (95% CI, 1.218-1.649) for dyslipidemia, and 2.080 (95% CI, 1.613-2.683) for central obesity. The odds ratio of a 10-year CVD risk of >30% for the third vs. the first tertile of MHR was 4.607 (95% CI, 2.648-8.017) and 3.397 (95% CI, 1.958-5.849) for SIRI. CONCLUSIONS MHR and SIRI had a significant association with MetD and its components, in which a higher level of MHR or SIRI tended to accompany a higher risk of metabolic diseases. Furthermore, they also correlated with CVD, and the increment of these indicators caused a gradually evaluated risk of 10-year CVD risk.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Yu Hua
- *Correspondence: Yu Hua, ; Yingxian Sun,
| |
Collapse
|