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Wang R, Zhao R, Liang Z, Chen K, Zhu X. A Nomogram Based on Platelet Distribution Width-to-Lymphocyte Ratio to Predict Overall Survival in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma. J Inflamm Res 2024; 17:4297-4308. [PMID: 38973997 PMCID: PMC11227859 DOI: 10.2147/jir.s462833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/18/2024] [Indexed: 07/09/2024] Open
Abstract
Purpose To evaluate the prognostic significance of platelet distribution width-to-lymphocyte ratio (PDWLR) in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Moreover, a nomogram based on PDWLR was built and validated to predict the overall survival (OS) of this population. Patients and Methods All LA-NPC patients who were diagnosed and treated between January 2015 and December 2017 at Guangxi Medical University Cancer Hospital were included. Cox regression analyses were performed to assess PDWLR and clinical features that might affect OS to screen for independent predictors. The independent predictors and important clinical variables were used to build and validate a nomogram for predicting OS. Then, the capability of the model was estimated by discrimination, calibration and clinical usefulness. Risk stratification was conducted using the nomogram-calculated risk score, and the comparison of survival in the high-risk group and the low-risk group was through Kaplan-Meier method. Results This study included 746 LA-NPC patients. Multivariate Cox analysis suggested that age (hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.18-2.78, P = 0.007), gender (HR: 2.03, 95% CI: 1.12-3.68, P = 0.019), pre-treatment plasma Epstein-Barr virus (EBV) DNA (HR: 1.55, 95% CI: 1.01-2.39, P = 0.047), PDWLR (HR: 2.61, 95% CI: 1.67-4.09, P < 0.001) were independent predictors of OS. Compared to the 8th edition TNM staging system, the nomogram based on the above four factors and important clinical variables (T stage and N stage) demonstrated better predictive performance. Moreover, the model had the ability to identify individuals at high risk. Conclusion PDWLR was a promising negative predictor for patients with LA-NPC. The nomogram based on PDWLR demonstrated better predictive performance than the current staging system.
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Affiliation(s)
- Runzhi Wang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People’s Republic of China
| | - Rong Zhao
- Department of Radiation, Inner Mongolia Autonomous Region People’s Hospital, Hohhot, Inner Mongolia autonomous Region, 010020, People’s Republic of China
| | - Zhongguo Liang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People’s Republic of China
| | - Kaihua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People’s Republic of China
| | - Xiaodong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People’s Republic of China
- Department of Oncology, Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, 530199, People’s Republic of China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, 530021, People’s Republic of China
- Guangxi Clinical Medicine Research Center of Nasopharyngeal Carcinoma, Nanning, Guangxi, 530021, People’s Republic of China
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Nanning, Guangxi, 530021, People’s Republic of China
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Yilmaz R, Yagin FH, Colak C, Toprak K, Abdel Samee N, Mahmoud NF, Alshahrani AA. Analysis of hematological indicators via explainable artificial intelligence in the diagnosis of acute heart failure: a retrospective study. Front Med (Lausanne) 2024; 11:1285067. [PMID: 38633310 PMCID: PMC11023638 DOI: 10.3389/fmed.2024.1285067] [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: 08/29/2023] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Acute heart failure (AHF) is a serious medical problem that necessitates hospitalization and often results in death. Patients hospitalized in the emergency department (ED) should therefore receive an immediate diagnosis and treatment. Unfortunately, there is not yet a fast and accurate laboratory test for identifying AHF. The purpose of this research is to apply the principles of explainable artificial intelligence (XAI) to the analysis of hematological indicators for the diagnosis of AHF. Methods In this retrospective analysis, 425 patients with AHF and 430 healthy individuals served as assessments. Patients' demographic and hematological information was analyzed to diagnose AHF. Important risk variables for AHF diagnosis were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) feature selection. To test the efficacy of the suggested prediction model, Extreme Gradient Boosting (XGBoost), a 10-fold cross-validation procedure was implemented. The area under the receiver operating characteristic curve (AUC), F1 score, Brier score, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were all computed to evaluate the model's efficacy. Permutation-based analysis and SHAP were used to assess the importance and influence of the model's incorporated risk factors. Results White blood cell (WBC), monocytes, neutrophils, neutrophil-lymphocyte ratio (NLR), red cell distribution width-standard deviation (RDW-SD), RDW-coefficient of variation (RDW-CV), and platelet distribution width (PDW) values were significantly higher than the healthy group (p < 0.05). On the other hand, erythrocyte, hemoglobin, basophil, lymphocyte, mean platelet volume (MPV), platelet, hematocrit, mean erythrocyte hemoglobin (MCH), and procalcitonin (PCT) values were found to be significantly lower in AHF patients compared to healthy controls (p < 0.05). When XGBoost was used in conjunction with LASSO to diagnose AHF, the resulting model had an AUC of 87.9%, an F1 score of 87.4%, a Brier score of 0.036, and an F1 score of 87.4%. PDW, age, RDW-SD, and PLT were identified as the most crucial risk factors in differentiating AHF. Conclusion The results of this study showed that XAI combined with ML could successfully diagnose AHF. SHAP descriptions show that advanced age, low platelet count, high RDW-SD, and PDW are the primary hematological parameters for the diagnosis of AHF.
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Affiliation(s)
- Rustem Yilmaz
- Department of Cardiology, Samsun Training and Research Hospital, Samsun University Faculty of Medicine, Samsun, Türkiye
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Türkiye
| | - Cemil Colak
- Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Türkiye
| | - Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanlıurfa, Türkiye
| | - Nagwan Abdel Samee
- Department of Information Technology, College of Computer and Information Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Noha F. Mahmoud
- Department of Rehabilitation Sciences, Health and Rehabilitation Sciences College, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amnah Ali Alshahrani
- Department of Computer Science, Applied College, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Wang L, Qin X, Zhang Y, Xue S, Song X. The prognostic predictive value of systemic immune index and systemic inflammatory response index in nasopharyngeal carcinoma: A systematic review and meta-analysis. Front Oncol 2023; 13:1006233. [PMID: 36816962 PMCID: PMC9936064 DOI: 10.3389/fonc.2023.1006233] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Objective To study the predictive value of systemic immune index (SII) and systemic inflammatory response index (SIRI) in the prognosis of patients with nasopharyngeal carcinoma. Methods Two researchers independently searched PubMed, Cochrane, Embase, and Web of Science databases (until March 18, 2022) for all studies on SII, SIRI, and prognosis in patients with nasopharyngeal carcinoma. Quality assessment of included studies was assessed using the Newcastle-Ottawa Scale (NOS). In addition, a bivariate mixed-effects model was used to explore predictive value. Results A total of 9 studies that satisfied the requirements were included, involving, 3187 patients with nasopharyngeal carcinoma. The results of the meta-analysis showed that SII could be an independent predictor of OS (HR=1.78, 95%CI [1.44-2.20], Z=5.28, P<0.05), and SII could also be an independent predictor of PFS (HR=1.66, 95%CI [1.36-2.03], Z=4.94, P<0.05). In addition, SIRI could also serve as an independent predictor of OS (HR=2.88, 95%CI [1.97-4.19], Z=5.51, P<0.05). The ROC area was 0.63, the sensitivity was 0.68 (95%CI [0.55-0.78]), and the specificity was 0.55 (95%CI [0.47-0.62]), all of which indicated that SII had a certain predictive value for OS. Conclusion SII and SIRI can be used as independent predictors to predict the prognosis and survival status of patients with nasopharyngeal carcinoma and have certain predictive accuracy. Therefore, SII and SIRI should be considered in studies that update survival risk assessment systems. Systematic Review Registration https://www.ytyhdyy.com/, identifier PROSPERO (CRD42022319678).
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Affiliation(s)
- Li Wang
- Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai Shandong, China,*Correspondence: Li Wang, ; Xicheng Song,
| | - Xianfei Qin
- School of Clinical Medicine, Binzhou Medical University, Yantai, China
| | - Yu Zhang
- Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai Shandong, China
| | - Shouyu Xue
- Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai Shandong, China
| | - Xicheng Song
- Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai Shandong, China,*Correspondence: Li Wang, ; Xicheng Song,
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Liu Q, Ma L, Ma H, Yang L, Xu Z. Establishment of a prognostic nomogram for patients with locoregionally advanced nasopharyngeal carcinoma incorporating clinical characteristics and dynamic changes in hematological and inflammatory markers. Front Oncol 2022; 12:1032213. [DOI: 10.3389/fonc.2022.1032213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/11/2022] [Indexed: 12/08/2022] Open
Abstract
BackgroundThis study aims to investigate the prognostic value of changes in hematological and inflammatory markers during induction chemotherapy (IC) and concurrent chemo-radiation (CCRT), thus construct nomograms to predict progression free survival (PFS) of patients with locally advanced nasopharyngeal carcinoma (LANPC).Methods130 patients were included in this prospective analysis. Univariate and multivariate cox regression analyses were conducted to identify prognostic factors. Three multivariate analyses integrating different groups of variables were conducted independently. Concordance indexes (c-index), calibration plots and Kaplan-Meier curves were used to evaluate the nomograms. Bootstrap validation was performed to determine the accuracy of the nomogram using 1000 resamples. The performances of proposed nomograms and TNM staging system were compared to validate the prognostic value of hematological and inflammatory markers.ResultsPretreatment gross tumor volume of nodal disease (GTVn), Δe/bHGB (hemoglobin count at end of treatment/baseline hemoglobin count), and stage were selected as predictors for 3-year PFS in first multivariate analysis of clinical factors. The second multivariate analysis of clinical factors and all hematological variables demonstrated that ΔminLYM (minimum lymphocyte count during CCRT/lymphocyte count post-IC), pretreatment GTVn and stage were associated with 3-year PFS. Final multivariate analysis, incorporating all clinical factors, hematological variables and inflammatory markers, identified the following prognostic factors: pretreatment GTVn, stage, ΔmaxPLR (maximum platelet-to-lymphocyte ratio (PLR) during CCRT/PLR post-IC), and ΔminPLT (minimum platelet count during CCRT/platelet count post-IC). Calibration plots showed agreement between the PFS predicted by the nomograms and actual PFS. Kaplan–Meier curves demonstrated that patients in the high-risk group had shorter PFS than those in the low-risk group (P ≤ 0.001). The c-indexes of the three nomograms for PFS were 0.742 (95% CI, 0.639-0.846), 0.766 (95% CI, 0.661-0.871) and 0.815 (95% CI,0.737-0.893) respectively, while c-index of current TNM staging system was 0.633 (95% CI, 0.531-0.736).ConclusionWe developed and validated a nomogram for predicting PFS in patients with LANPC who received induction chemotherapy and concurrent chemo-radiation. Our study confirmed the prognostic value of dynamic changes in hematological and inflammatory markers. The proposed nomogram outperformed the current TNM staging system in predicting PFS, facilitating risk stratification and guiding individualized treatment plans.
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Chiang CL, Guo Q, Ng WT, Lin S, Ma TSW, Xu Z, Xiao Y, Li J, Lu T, Choi HCW, Chen W, Chau ESC, Luk PHY, Huang SH, O'Sullivan B, Pan J, Lee AWM. Prognostic Factors for Overall Survival in Nasopharyngeal Cancer and Implication for TNM Staging by UICC: A Systematic Review of the Literature. Front Oncol 2021; 11:703995. [PMID: 34540670 PMCID: PMC8445029 DOI: 10.3389/fonc.2021.703995] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022] Open
Abstract
This study aims to identify prognostic factors in nasopharyngeal carcinoma (NPC) to improve the current 8th edition TNM classification. A systematic review of the literature reported between 2013 and 2019 in PubMed, Embase, and Scopus was conducted. Studies were included if (1) original clinical studies, (2) ≥50 NPC patients, and (3) analyses on the association between prognostic factors and overall survival. The data elements of eligible studies were abstracted and analyzed. A level of evidence was synthesized for each suggested change to the TNM staging and prognostic factors. Of 5,595 studies screened, 108 studies (44 studies on anatomical criteria and 64 on non-anatomical factors) were selected. Proposed changes/factors with strong evidence included the upstaging paranasal sinus to T4, defining parotid lymph node as N3, upstaging N-category based on presence of lymph node necrosis, as well as the incorporation of non-TNM factors including EBV-DNA level, primary gross tumor volume (GTV), nodal GTV, neutrophil-lymphocyte ratio, lactate dehydrogenase, C-reactive protein/albumin ratio, platelet count, SUVmax of the primary tumor, and total lesion glycolysis. This systematic review provides a useful summary of suggestions and prognostic factors that potentially improve the current staging system. Further validation studies are warranted to confirm their significance.
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Affiliation(s)
- Chi Leung Chiang
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Qiaojuan Guo
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Wai Tong Ng
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shaojun Lin
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Tiffany Sze Wai Ma
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Zhiyuan Xu
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Youping Xiao
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jishi Li
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Tianzhu Lu
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Horace Cheuk Wai Choi
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wenqi Chen
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Eric Sze Chun Chau
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Peter Ho Yin Luk
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shao Hui Huang
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Brian O'Sullivan
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jianji Pan
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Anne Wing Mui Lee
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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6
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Zhou X, Chen H, Zhang W, Li X, Si X, Zhang G. Predictive Value of Routine Blood Test in patients with Early Esophageal Cancer: A Matched Case-Control Study. J Cancer 2021; 12:4739-4744. [PMID: 34149937 PMCID: PMC8210552 DOI: 10.7150/jca.56029] [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: 11/17/2020] [Accepted: 05/24/2021] [Indexed: 11/23/2022] Open
Abstract
Aims: The present study was to evaluate the diagnostic value of routine blood test as potential inflammatory markers in early esophageal cancer (EEC) patients. Methods: A matched case-control study was conducted by recruiting 314 patients who were pathologically diagnosed with EEC and then underwent Endoscopic Submucosal Dissection (ESD) from July 2015 to July 2019 in First Affiliated Hospital of Nanjing Medical University. Each EEC patient was matched against one healthy control on the criteria of gender, and age (±2 years). Additionally, a total of 40 subjects (20 cases and 20 controls) were also included in the validation set. Statistical analysis of selected hematological parameters was performed between the two groups. The correlation between preoperative blood indexes and clinicopathological characteristics after ESD in EEC patients were further assessed. Results: Mono-factor analysis showed that the index of monocyte (p<0.001), MCV (p=0.018), MCH (p=0.01), MPV (p=0.022), PT (p=0.003), PT-INR (p=0.003), PDW (p<0.001) and MLR (p<0.001) were statistically significant in EEC patients when compared with those in healthy controls. Multivariate logistic regression analysis further identified that PDW and MLR was independently associated with the risk of early esophageal cancer (both p<0.001). The higher level of NLR (P=0.007) and MLR (P=0.015) were statistically significant with submucosal invasion in EEC patients and the level of MLR were significantly associated with larger tumor size (P=0.030). The results of the validation group were in consistence with the primary group. Conclusions: Hematological parameters of MLR and PDW can be used as an adjuvant tool for the diagnosis of EEC. Moreover, the value of MLR can reflect the invasion depth index.
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Affiliation(s)
- Xiaoying Zhou
- Department of Gastroenterology, First Affiliated hospital of Nanjing medical university
| | - Han Chen
- Department of Gastroenterology, First Affiliated hospital of Nanjing medical university
| | - Weifeng Zhang
- Department of Gastroenterology, First Affiliated hospital of Nanjing medical university
| | - Xueliang Li
- Department of Gastroenterology, First Affiliated hospital of Nanjing medical university
| | - Xinmin Si
- Department of Gastroenterology, First Affiliated hospital of Nanjing medical university
| | - Guoxin Zhang
- Department of Gastroenterology, First Affiliated hospital of Nanjing medical university
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7
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Kong W, Yang M, Zhang J, Cheng Y, Dai T, Zhang J, Wang G, Zhang J. Prognostic value of inflammation-based indices in patients with resected hepatocellular carcinoma. BMC Cancer 2021; 21:469. [PMID: 33906632 PMCID: PMC8077869 DOI: 10.1186/s12885-021-08153-4] [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: 05/15/2020] [Accepted: 04/06/2021] [Indexed: 01/20/2023] Open
Abstract
Background As is well recognized that inflammation plays a crucial role in the genesis and progression of various cancer. Here we investigate the prognostic value of a novel index: the combination of neutrophil to lymphocyte ratio and platelet distribution width (coNLR-PDW) in post-operation patients with resectable hepatocellular carcinoma (HCC). Methods The receiver operating characteristic (ROC) curve was utilized to determine the optimal cutoff values of continuous variables, including the neutrophil-lymphocyte ratio (NLR) and platelet distribution width (PDW). Kaplan-Meier method and the Log-rank test were used to compare survival differences across three groups stratified by the coNLR-PDW score. Univariate and multivariate Cox proportional hazard regression analyses were adopted to identify independent factors of HCC patient’s prognosis. Results 1.59 and 13.0 were perceived as the optimal cutoff value for NLR and PDW based on the ROC curve, respectively. Kaplan-Meier method revealed that a higher coNLR-PDW score predicts poorer overall survival (OS) and disease-free survival (DFS) (P < 0.001). coNLR-PDW was demonstrated as an independent factor for both OS and DFS using Cox regression analysis in training and validation cohort. Conclusion coNLR-PDW is recognized as a valuable biomarker for predicting the survival of patients with HCC. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08153-4.
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Affiliation(s)
- Weihao Kong
- Department of Emergency Surgery, Department of Emergency Medicine, the First affiliated hospital of Anhui Medical University, 218 Jixi Avenue, Hefei, 230022, China
| | - Mingwei Yang
- Department of Radiation Oncology, the First affiliated hospital of Anhui Medical University, Hefei, China
| | - Jianfeng Zhang
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Ya Cheng
- Department of Emergency Surgery, Department of Emergency Medicine, the First affiliated hospital of Anhui Medical University, 218 Jixi Avenue, Hefei, 230022, China
| | - Tianxing Dai
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Jian Zhang
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.,Organ Transplantation Institute of Sun Yat-sen University, Guangzhou, China
| | - Guoying Wang
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China. .,Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Jianlin Zhang
- Department of Emergency Surgery, Department of Emergency Medicine, the First affiliated hospital of Anhui Medical University, 218 Jixi Avenue, Hefei, 230022, China.
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Go H, Ohto H, Nollet KE, Kashiwabara N, Chishiki M, Hoshino M, Ogasawara K, Kawasaki Y, Momoi N, Hosoya M. Perinatal factors affecting platelet parameters in late preterm and term neonates. PLoS One 2020; 15:e0242539. [PMID: 33211743 PMCID: PMC7676724 DOI: 10.1371/journal.pone.0242539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 11/04/2020] [Indexed: 12/21/2022] Open
Abstract
Platelets parameters including platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) are associated with various physiological and pathological functions in various disease. However, few studies have addressed whether perinatal factors may be associated with platelet parameters at birth in a large cohort of late preterm and term neonates. The aim of this study to investigate perinatal factors affecting platelet parameters in late preterm and term neonates. We retrospectively investigated platelet parameters including PLT, PCT, MPV, and PDW on the first day of life in 142 late preterm and 258 term neonates admitted to our NICU from 2006 through 2020. PLT, MPV, PCT, PDW on Day 0 did not significantly differ between the two groups. In term neonates, multivariate analysis revealed that PCT correlated with being small for gestational age (SGA) (β = -0.168, P = 0.006), pregnancy induced hypertension (PIH) (β = -0.135, P = 0.026) and male sex (β = -0.185, P = 0.002). PLT was associated with SGA (β = -0.186, P = 0.002), PIH (β = -0.137, P = 0.024) and male sex (β = -0.166, P = 0.006). In late preterm neonates, multivariate analysis revealed that PLT were associated with PIH, whereas no factors associated with PDW and MPV were found. In all patients studied, chorioamnionitis (CAM) was significantly associated with MPV (CAM = 10.3 fL vs. no CAM = 9.7 fL, P<0.001). Multivariate analysis showed that SGA, male sex and PIH were associated with PCT and PLT. This study demonstrates that different maternal and neonatal complications affect platelet parameters in late preterm and term neonates.
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Affiliation(s)
- Hayato Go
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
- * E-mail:
| | - Hitoshi Ohto
- Department of Advanced Cancer Immunotherapy, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenneth E. Nollet
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nozomi Kashiwabara
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mina Chishiki
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masato Hoshino
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kei Ogasawara
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukihiko Kawasaki
- Department of Pediatrics, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Nobuo Momoi
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
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9
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Lau HC, Hsueh CY, Chen Q, Tao L, Zhou L, Deng W, Zhang M. Prognostic values of preoperative platelet-to-lymphocyte ratio and platelet-related indices in advanced hypopharyngeal squamous cell carcinoma. Clin Otolaryngol 2020; 45:221-230. [PMID: 31850682 DOI: 10.1111/coa.13497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 10/10/2019] [Accepted: 12/12/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To investigate the prognostic values of preoperative platelet-to-lymphocyte ratio (PLR) and platelet-related indices in advanced hypopharyngeal squamous cell carcinoma (HPSCC). METHODS The data of 247 eligible advanced HPSCC patients were reviewed retrospectively. Pretreatment haematological parameters were categorised into two groups based on the result of X-tile, and several variates were assessed using chi-square test, Kaplan-Meier method, Cox univariate and multivariate analysis. RESULTS The optimal cut-off points of 171.4 for PLR, 260 × 109 /L for platelet, 10.4 fL for mean platelet volume (MPV) and 16.5% for platelet distribution width were defined. The haematological parameters PLR and MPV, postoperative metastasis and internal jugular vein invasion were statistically significant in OS and DFS analyses (P < .05). The high PLR (>171.4) or high MPV (>10.4 fL) was significantly associated with worse OS and DFS (P < .05). CONCLUSIONS The preoperative levels of PLR and MPV could be considered as independent prognostic predictors in patients with advanced HPSCC.
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Affiliation(s)
- Hui-Ching Lau
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai, China
| | - Chi-Yao Hsueh
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai, China
| | - Qi Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai, China.,Department of Otolaryngology, Jing'an District Centre Hospital of Shanghai, Shanghai, China
| | - Lei Tao
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai, China
| | - Liang Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai, China
| | - Weiye Deng
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ming Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai, China
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10
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Tzur I, Barchel D, Izhakian S, Swarka M, Garach-Jehoshua O, Krutkina E, Plotnikov G, Gorelik O. Platelet distribution width: a novel prognostic marker in an internal medicine ward. J Community Hosp Intern Med Perspect 2019; 9:464-470. [PMID: 32002150 PMCID: PMC6968671 DOI: 10.1080/20009666.2019.1688095] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/17/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Platelet distribution width (PDW) has demonstrated clinical significance in populations with specific disorders; its prognostic significance in internal medicine wards has not been investigated. Methods: Demographic, clinical and laboratory data were collected prospectively for 1036 internal medicine inpatients. The primary outcome was 90-day mortality, secondary outcomes were: treatment with mechanical ventilation, prolonged hospital stay, in-hospital death, and all-cause mortality following discharge. Data were assessed according to PDW values on admission ≤16.7% (group A) and >16.7% (group B). Results: Compared to group A patients (n = 273), group B patients (n = 763) were more likely to be older, admitted for cardio-cerebrovascular disorder, to present with comorbidities, to be mechanically ventilated, to have prolonged hospital stay and to die during the current hospitalization. The respective 90-day and total (median follow-up of 5 months) mortality rates were significantly higher in group B (13.2% and 16.3%) than in group A (6.6% and 9.5%), P < 0.01. On multivariate analysis, higher PDW values on admission predicted 90-day mortality and shortened survival (relative risks 1.58 and 1.26; 95% confidence intervals 0.89 - 2.78 and 0.97-1.64, respectively). Conclusion: Higher PDW values on admission to internal medicine wards are associated with a more severe clinical profile and increased risk of 90-day mortality.
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Affiliation(s)
- Irma Tzur
- Department of Internal Medicine "F", Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Dana Barchel
- Department of Internal Medicine "F", Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Shimon Izhakian
- Department of Internal Medicine "F", Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Muhareb Swarka
- Department of Internal Medicine "F", Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Osnat Garach-Jehoshua
- Division of Hematology, Shamir (Assaf Harofeh) Medical Center (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv), Zerifin, Israel
| | - Ekaterina Krutkina
- Division of Hematology, Shamir (Assaf Harofeh) Medical Center (affiliated to Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv), Zerifin, Israel
| | - Galina Plotnikov
- Department of Internal Medicine "F", Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Oleg Gorelik
- Department of Internal Medicine "F", Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
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11
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Zhang X, Qin YY, Chen M, Wu YY, Lin FQ. Combined Use of Mean Platelet Volume/Platelet Count Ratio and Platelet Distribution Width to Distinguish Between Patients with Nasopharyngeal Carcinoma, Those with Benign Tumors of the Nasopharynx, and Healthy Subjects. Cancer Manag Res 2019; 11:10375-10382. [PMID: 31849526 PMCID: PMC6913058 DOI: 10.2147/cmar.s226050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/20/2019] [Indexed: 01/13/2023] Open
Abstract
Purpose For the diagnosis of nasopharyngeal carcinoma (NPC), reliable early indicators with sensitivity and specificity should be sought. This study evaluated the effect of the combined use of mean platelet volume/platelet count ratio (MPV/PC ratio) and platelet distribution width (PDW) for differential diagnosis of NPC. In this study, MPV/PC ratio was used for the first time to diagnostically evaluate NPC. Patients and methods We retrospectively analyzed various hematological indices of three subject groups (208, 185, and 162 patients with NPC, benign tumors of the nasopharynx, and healthy subjects, respectively) and evaluated the value of combined use of MPV/PC ratio and PDW for differential diagnosis of the three groups using the one-way analysis of variance. Results Comparison of laboratory variables between the three groups showed a significant difference in MPV/PC ratio and PDW (P<0.001, all). The MPV/PC ratio in the NPC group was significantly lower than the other two groups (P<0.001); MPV/PC ratio also showed a statistically significant difference in different stages (P=0.034) and serosal invasions (P<0.001) of the NPC group. Receiver operating characteristic curve (ROC) analysis showed that areas under the curve (AUC) of either patients with benign tumors of the nasopharynx (AUCMPV/PCratio+PDW: 0.708) or healthy subjects (AUCMPV/PCratio+PDW: 0.909) were larger than those of MPV/PC ratio (AUCMPV/PCratio: 0.665, 0.869, respectively) and PDW (AUCPDW:0.614, 0.716, respectively) use alone (P<0.05, all). Conclusion MPV/PC ratio and PDW may be used as indexes of NPC. MPV/PC ratio combined with PDW could be considered as meaningful laboratory indexes for differential diagnosis of NPC, benign tumors of the nasopharynx, and healthy subjects. This finding could enhance the detection of NPC.
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Affiliation(s)
- Xuan Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Yuan-Yuan Qin
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Min Chen
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Yang-Yang Wu
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Fa-Quan Lin
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
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12
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Song J, Lai X, Zhang Y, Zheng X, Su J. Preoperative platelet morphology parameters as prognostic predictors for endometrial malignant carcinoma stage and progesterone receptor. Medicine (Baltimore) 2019; 98:e17818. [PMID: 31764773 PMCID: PMC6882632 DOI: 10.1097/md.0000000000017818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
To investigate preoperative platelet morphology parameters and other whole blood cells in patients of malignant endometrial carcinoma compared with benign disease.Retrospective analysis was performed through collecting patients' hematological parameters before performing total abdominal/vaginal hysterectomy and standard radical surgery due to benign and malignant endometrial disease between 2006 and 2017. Parameters required included white blood cell (WBC), hemoglobin, platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet thrombocytocrit (PCT). And neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated. For malignant carcinoma, Ki-67 percentage and progesterone receptor (PR) status were further collected.A total of 288 patients were included with 145 benign cases and 143 malignant cases. Patients of confirmed endometrial carcinoma showed a significant lower value of PDW (55.21 ± 4.72 vs 49.54 ± 5.89, P < .001), meanwhile significant higher values of MPV (7.12 ± 1.56 vs 8.89 ± 1.67, P < .001) and PCT (24.18 ± 6.89 vs 27.93 ± 8.93, P = .003). Further analysis of endometrial carcinoma patients showed that no significant difference in platelet parameters was found between patients with stage I to II and stage III to IV (P > .05), while increased value in PDW and reduced value in MPV was found in PR negative compared with positive patients.Preoperative platelet morphology parameters seemed to be used as one kind of predictive factors to discriminate malignant and benign endometrial disease. Limited by present study design, further prospective studies are required to support this finding.
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13
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Zuo X, Kong W, Feng L, Zhang H, Meng X, Chen W. Elevated platelet distribution width predicts poor prognosis in hepatocellular carcinoma. Cancer Biomark 2019; 24:307-313. [PMID: 30829614 DOI: 10.3233/cbm-182076] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Previous studies have demonstrated that platelets play an important role in growth, invasion, and angiogenesis of a variety of tumors. Nevertheless, the prognostic role of platelet indices in hepatocellular carcinoma (HCC) has not been explored. The aim of this study was to explore the association between platelet indices and prognosis in HCC. METHOD A total of 260 patients with HCC between January 2009 and December 2015 were retrospectively analyzed. The optimal platelet distribution width (PDW) cutoff value is identified by the receiver operating characteristic curve (ROC) curve. The relationship between PDW and clinicopathological features was assessed. The prognostic effects of PDW were assessed by using the Kaplan-Meier method and Cox regression model. RESULT Elevated PDW level was significantly associated with portal hypertension, vascular invasion, and Child-Pugh grade. In addition, survival curve indicates that patients with high PDW levels have a worse prognosis than patients with low PDW levels (P< 0.001). Multivariate Cox regression analysis identified PDW as an independent factor of prognosis in HCC patients (hazard ratio: 4.460, 95% confidence interval: 2.308-8.619, P< 0.001). CONCLUSION Elevated PDW may be a novel marker for predicting the prognosis of HCC, but further research is needed to validate our conclusions.
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Affiliation(s)
- Xiaomin Zuo
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.,Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Weihao Kong
- Department of Emergency Surgery, Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.,Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Linfei Feng
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.,Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Huabing Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Anhui Medical University, Hefei, Anhui, China
| | - Xiangling Meng
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wei Chen
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Xia W, Chen W, Tu J, Ni C, Meng K. Prognostic Value and Clinicopathologic Features of Platelet Distribution Width in Cancer: A Meta-Analysis. Med Sci Monit 2018; 24:7130-7136. [PMID: 30291788 PMCID: PMC6187965 DOI: 10.12659/msm.913040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The association between platelet distribution width (PDW) and cancer has been evaluated by a few studies, but the influence of PDW on cancer prognosis is unclear. Therefore, we conducted the present meta-analysis. MATERIAL AND METHODS We identified relevant research using identical search strategies. The influence of PDW level on cancer prognosis, as well as clinical characteristics, was analyzed. RESULTS A total of 11 studies comprising 2625 cancer patients were included in our meta-analysis. The results suggested that high PDW level was obviously related to poor OS (HR=1.54, 95%CI 1.18-2.00), especially for breast cancer (HR=1.21, 95%CI 1.07-1.36) and pharyngolaryngeal cancer (HR=3.06, 95%CI 1.68-5.57). Furthermore, high PDW was obviously related to poor OS both in older and younger subgroups, with combined HR estimates of 1.58 (95%CI 1.15-2.16) and 1.64 (95%CI 1.19-2.26), respectively. High PDW level was notably related to poor OS in the cut-off value ³16% subgroup (HR=1.84, 95%CI 1.01-3.40). Moreover, high PDW level was obviously associated with lymph node metastasis (OR=1.43, 95%CI 1.04-1.99). CONCLUSIONS The findings of this study suggest that PDW is an effective and convenient indicator of cancer prognosis. Furthermore, high PDW level is obviously associated with lymph node metastasis.
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Affiliation(s)
- Wenjie Xia
- Department of Thyroid and Breast Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Wuzhen Chen
- Department of Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland)
| | - Jiangfeng Tu
- Department of Gastroenterology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Chao Ni
- Department of Thyroid and Breast Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Kexin Meng
- Department of Thyroid and Breast Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (mainland)
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15
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Li K, Wang R, Huang S, Pan X, Chen H, Zhou L, Wei J, Wu C, Zhu X, Liang S, Qu S. Prognostic Nomogram for Overall Survival in Extranodal Natural Killer/T-Cell Lymphoma Patients. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:e537-e543. [PMID: 30243570 DOI: 10.1016/j.clml.2018.08.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/29/2018] [Accepted: 08/21/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Extranodal natural killer/T-cell lymphoma (ENKTL) is a rare lymphoid malignancy with diverse clinical features and prognoses. The aims of this study were to explore the pretreatment prognostic factors of ENKTL and develop a new individual prognostic model. PATIENTS AND METHODS We retrospectively enrolled 81 ENKTL patients with newly diagnosed disease between June 2006 and August 2017 at the Affiliated Cancer Hospital of Guangxi Medical University. Survival analysis was used to assess the prognostic value of various factors. A nomogram was developed to predict overall survival (OS) based on the Cox proportional hazards model. RESULTS The median survival time of the patients was 48 months, and the 5-year OS rate was 47.5%. Cox regression analysis showed that the prognostic factors of OS for ENKTL patients included Eastern Cooperative Oncology Group performance status, Ann Arbor stage, pretreatment albumin-to-globulin ratio, and platelet count. A prognostic nomogram was developed to predict the OS rate for ENKTL patients based on these factors. The calibration curve showed that the nomogram was able to predict OS accurately. The concordance index of the nomogram for OS prediction was 0.807. CONCLUSION Our proposed nomogram based on Eastern Cooperative Oncology Group performance status, Ann Arbor stage, albumin-to-globulin ratio, and platelet count provides an individualized risk estimate of OS in patients with ENKTL.
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Affiliation(s)
- Kaiguo Li
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Ruyue Wang
- Emergency Department of Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China
| | - Shiting Huang
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Xinbin Pan
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Hongmin Chen
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Lei Zhou
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Junbao Wei
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Chunhua Wu
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Xiaodong Zhu
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Shixiong Liang
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China
| | - Song Qu
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China.
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16
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Gao ZM, Wang RY, Deng P, Ding P, Zheng C, Hou B, Li K. TNM-PNI: a novel prognostic scoring system for patients with gastric cancer and curative D2 resection. Cancer Manag Res 2018; 10:2925-2933. [PMID: 30214287 PMCID: PMC6118288 DOI: 10.2147/cmar.s169206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose Gastric cancer (GC) is one of the most common malignancies and has a high mortality rate. In recent years, several nutritional or inflammatory biomarkers have been shown to effectively predict the prognosis of tumors. In this study, we intended to establish a prognostic scoring system for GC patients. Patients and methods Our study included a total of 501 GC patients who were diagnosed with GC stage I–III and received curative gastrectomy with D2 lymphadenectomy between January 2011 and December 2012. Survival analysis was performed using Kaplan–Meier and log-rank tests. Two Cox multivariate models, one for continuous and one for categorical variables, were established to identify independent prognostic factors. All statistical analyses were performed using SPSS 20.0. Results Univariate and multivariate analyses revealed that tumor-node-metastasis (TNM) stage, preoperative prognostic nutritional index (PNI), and adjuvant therapy were independent prognostic factors for GC patients. We established a new composite variable, TNM-PNI, which was confirmed to be a major prognostic factor for curative D2 resection, independent of whether adjuvant therapy was administered. GC patients with higher TNM-PNI scores always had worse cancer outcomes. In addition, we found that adjuvant therapy might be beneficial for the survival of GC patients with TNM-PNI =4 or 5. Conclusion Preoperative PNI plays a distinctly subsidiary role to the TNM stage when predicting patient prognosis. TNM-PNI is a novel and an effective prognostic index for GC patients with curative D2 resection and a good supplement for the National Comprehensive Cancer Network Guidelines.
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Affiliation(s)
- Zi-Ming Gao
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China,
| | - Rui-Ying Wang
- Department of Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Peng Deng
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China,
| | - Peng Ding
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China,
| | - Chen Zheng
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China,
| | - Bin Hou
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China,
| | - Kai Li
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China,
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Xie Y, Wen JB, Li X. Value of routine blood test in early diagnosis of gastric cancer and its relationship with Helicobacter pylori infection. Shijie Huaren Xiaohua Zazhi 2018; 26:904-911. [DOI: 10.11569/wcjd.v26.i15.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the value of each index of routine blood test in the early diagnosis of gastric cancer (GC), and investigate the effect of Helicobacter pylori (H. pylori) infection on routine blood indexes.
METHODS A total of 223 inpatients or hospitalized patients who underwent gastroscopy from September 2016 to September 2017 were selected and divided into four groups according to gastroscopic and pathological results, including 58 patients with chronic superficial gastritis (CSG), 59 patients with chronic atrophic gastritis (CAG), 52 patients with high-grade intraepithelial neoplasia (HIN), and 57 patients with GC. Red blood cell distribution width (RDW), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), white blood cell count (WBC), lymphocyte count (LYMP), neutrophil count (NR), neutrophil count to lymphocyte ratio (NLR), and platelet count to lymphocyte ratio (PLR) were compared in different groups, and the sensitivity and specificity of each index for diagnosis of GC were calculated. The effect of H. pylori infection on routine blood indexes was also analyzed.
RESULTS LYMP and MPV gradually decreased and RDW, NLR, and PLR gradually increased from CSG to CAG, HIN, and GC. RDW, MPV, LYMP, NLR, and PLR were all significantly different between the CSG group and GC group (P < 0.05). In detecting GC, the sensitivities of RDW, MPV, LYMP, NLR, PLR, and NC were 82.5%, 80.7%, 84.2%, 84.2%, 71.9%, and 45.6%, respectively, and the specificities were 72.4%, 55.2%, 82.8%, 91.0%, 89.7%, and 89.7%, respectively. The positive rates of H. pylori in the CSG group, CAG group, HIN group, and GC group were 63.7%, 62.5%, 63.5%, and 66.7%, respectively. In the CSG group, PLT, WBC, and NR were significantly higher in H. pylori positive patients than in H. pylori negative patients (P < 0.05). There were no significant differences in blood routine indexes between H. pylori positive and H. pylori negative patients in the CAG, HIN, and GC groups (P > 0.05).
CONCLUSION RDW, PLT, MPV, LYMP, NLR, and PLR can be used in the early diagnosis of GC. H. pylori infection can lead to systemic inflammatory reactions. Early eradication of H. pylori is beneficial to the prevention of GC.
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Affiliation(s)
- Yan Xie
- Department of Gastroenterology, Affiliated Pingxiang Hospital of Southern Medical University, Pingxiang 337000, Jiangxi Province, China
| | - Jian-Bo Wen
- Department of Gastroenterology, Affiliated Pingxiang Hospital of Southern Medical University, Pingxiang 337000, Jiangxi Province, China
| | - Xing Li
- Department of Gastroenterology, Affiliated Pingxiang Hospital of Southern Medical University, Pingxiang 337000, Jiangxi Province, China
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