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Stares M, Brown LR, Abhi D, Phillips I. Prognostic Biomarkers of Systemic Inflammation in Non-Small Cell Lung Cancer: A Narrative Review of Challenges and Opportunities. Cancers (Basel) 2024; 16:1508. [PMID: 38672590 PMCID: PMC11048253 DOI: 10.3390/cancers16081508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Non-small cell lung cancer (NSCLC) is a common malignancy and is associated with poor survival outcomes. Biomarkers of systemic inflammation derived from blood tests collected as part of routine clinical care offer prognostic information for patients with NSCLC that may assist clinical decision making. They are an attractive tool, as they are inexpensive, easily measured, and reproducible in a variety of healthcare settings. Despite the wealth of evidence available to support them, these inflammatory biomarkers are not yet routinely used in clinical practice. In this narrative review, the key inflammatory indices reported in the literature and their prognostic significance in NSCLC are described. Key challenges limiting their clinical application are highlighted, including the need to define the optimal biomarker of systemic inflammation, a lack of understanding of the systemic inflammatory landscape of NSCLC as a heterogenous disease, and the lack of clinical relevance in reported outcomes. These challenges may be overcome with standardised recording and reporting of inflammatory biomarkers, clinicopathological factors, and survival outcomes. This will require a collaborative approach, to which this field of research lends itself. This work may be aided by the rise of data-driven research, including the potential to utilise modern electronic patient records and advanced data-analysis techniques.
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Affiliation(s)
- Mark Stares
- Edinburgh Cancer Centre, NHS Lothian, Edinburgh EH4 2XU, UK
- Cancer Research UK Scotland Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - Leo R. Brown
- Cancer Research UK Scotland Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - Dhruv Abhi
- Edinburgh Cancer Centre, NHS Lothian, Edinburgh EH4 2XU, UK
| | - Iain Phillips
- Edinburgh Cancer Centre, NHS Lothian, Edinburgh EH4 2XU, UK
- Cancer Research UK Scotland Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
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2
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Roberts WS, Delladio W, Price S, Murawski A, Nguyen H. The efficacy of albumin-globulin ratio to predict prognosis in cancer patients. Int J Clin Oncol 2023; 28:1101-1111. [PMID: 37421476 DOI: 10.1007/s10147-023-02380-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
The goal of this systematic review was to identify all of the research within the last 10 years that investigated both the Albumin-Globulin Ratio (AGR) and outcomes of solid tumor cancer patients via quantitative prognostic variables. Multiple scientific databases were researched for journal articles that included keywords relating AGR to prognosis. Once isolated from the databases, the articles were de-duplicated and manually screened based on standardized inclusion/exclusion criteria in a blind format via Rayyan. The collective data were sorted by cancer type, corrected for population size, and used to calculate the average cut-off values for the most popular prognostic variables. In total, 18 independent types of cancer have been evaluated to see if AGR is a prognostic indicator based on multivariate analyses. The average cut-off value for AGR in overall survival was 1.356, while the average cut-off value for AGR in progression free survival was 1.292. AGR was found to be significantly associated with at least one prognostic variable in every type of cancer evaluated based on multivariate analyses. The ease of access and affordability of AGR makes it an invaluable tool applicable to nearly all patients. Overall, AGR is a proven prognostic variable that should always be considered in the evaluation of a solid tumor cancer patient's prognosis. Further research needs to be conducted studying the potential prognostic effect in more types of solid tumors.
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Affiliation(s)
- Will S Roberts
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA.
| | - William Delladio
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Shawn Price
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Alec Murawski
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Hoang Nguyen
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
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3
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Wang YT, Kuo LT, Lai CH, Tsai YH, Lee YC, Hsu CM, Liao CT, Kang CJ, Huang EI, Tsai MS, Chang GH, Tsai YT. Low Pretreatment Albumin-to-Globulin Ratios Predict Poor Survival Outcomes in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis. J Cancer 2023; 14:281-289. [PMID: 36741261 PMCID: PMC9891875 DOI: 10.7150/jca.80955] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/25/2022] [Indexed: 01/12/2023] Open
Abstract
Background: Studies have indicated that a low albumin-to-globulin ratio (AGR) before treatment is linked to poor prognosis of many cancers, but the prognostic impact of AGR remains controversial in head and neck cancer (HNC). This meta-analysis examined the prognostic value of AGR in HNC. Methods: We systematically searched the Embase, PubMed, and Cochrane library for relevant articles from inception to July 22, 2022. Studies conducted from 2000 to 2022 exploring the prognostic value of AGR in HNC were retrieved. We employed a random-effects model and calculated pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) to examine the associations of AGR with survival outcome. Results: Our analysis included nine studies involving 3211 patients with HNC. The pooled results revealed significant associations between low pretreatment AGRs and poor disease-free survival (HR = 1.97, 95% CI 1.58-2.45, p < 0.001), distant metastasis-free survival (HR = 1.64, 95% CI 1.25-2.16, p < 0.001), overall survival (HR = 2.18, 95% CI 1.65-2.88, p < 0.001), T3-T4 status (OR = 2.22, 95% CI 1.43-3.44, p < 0.001), stage III-IV disease (OR = 2.62, 95% CI 1.62-4.23, p < 0.001), and lymph node metastasis (OR = 1.95, 95% CI 1.29-2.82, p = 0.001) in patients with HNC. Conclusion: AGR can serve as a prognostic biomarker in managing HNC, and a low pretreatment AGR is strongly associated with adverse survival outcomes and advanced cancer status. Additional large-scale prospective trials must be conducted to assess the validity of our findings.
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Affiliation(s)
- Yun-Ting Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Liang-Tseng Kuo
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yuan-Hsiung Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Cheng-Ming Hsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Ta Liao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chung-Jan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ethan I. Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Shao Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Geng-He Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,✉ Corresponding author: Yao-Te Tsai, MD, Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. Address: No.6, W. Sec., Jiapu Rd., Puzih City, Chiayi County 613, Taiwan. E-mail: ; Tel: +886 975014653
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4
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Song M, Zhang Q, Song C, Liu T, Zhang X, Ruan G, Tang M, Xie H, Zhang H, Ge Y, Li X, Zhang K, Yang M, Li Q, Liu X, Lin S, Xu Y, Xu H, Wang K, Li W, Shi H. The advanced lung cancer inflammation index is the optimal inflammatory biomarker of overall survival in patients with lung cancer. J Cachexia Sarcopenia Muscle 2022; 13:2504-2514. [PMID: 35833264 PMCID: PMC9530543 DOI: 10.1002/jcsm.13032] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/17/2022] [Accepted: 05/12/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUNDS Malnutrition and systemic inflammatory responses are associated with poor overall survival (OS) in lung cancer patients, but it remains unclear which biomarkers are better for predicting their prognosis. This study tried to determine the best one among the existing common nutrition/inflammation-based indicators of OS for patients with lung cancer. MATERIALS AND METHODS There were 16 nutrition or systemic inflammation-based indicators included in this study. The cut-off points for the indicators were calculated using maximally selected rank statistics. The OS was evaluated using the Kaplan-Meier estimator, and univariate and multivariate Cox proportional hazard models were used to determine the relationship between the indicators and OS. A time-dependent receiver operating characteristic curves (time-ROC) and C-index were calculated to assess the predictive ability of the different indicators. RESULTS There were 1772 patients with lung cancer included in this study. In univariate analysis, all 16 indicators were significantly associated with OS of the patients (all P < 0.001). Except for platelet-to-lymphocyte ratio, all other indicators were independent predictors of OS in multivariate analysis (all P < 0.05). Low advanced lung cancer inflammation index (ALI) was associated with higher mortality risk of lung cancer [hazard ratio, 1.30; 95% confidence interval (CI), 1.13-1.49]. The results of the time-AUC and C-index analyses indicated that the ALI (C-index: 0.611) had the best predictive ability on the OS in patients with lung cancer. In different sub-groups, the ALI was the best indicator for predicting the OS of lung cancer patients regardless of sex (C-index, 0.609 for men and 0.613 for women) or smoking status (C-index, 0.629 for non-smoker and 0.601 for smoker) and in patients aged <65 years (C-index, 0.613). However, the modified Glasgow prognostic score was superior to the other indicators in non-small cell lung cancer patients (C-index, 0.639) or patients aged ≥65 years (C-index, 0.610), and the glucose-to-lymphocyte ratio performed better prognostic ability in patients with small cell lung cancer (C-index, 0.601). CONCLUSIONS The prognostic ability of the ALI is superior to the other inflammation/nutrition-based indicators for all patients with lung cancer.
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Affiliation(s)
- Mengmeng Song
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Chunhua Song
- Department of Epidemiology and Statistics, Henan Key Laboratory of Tumor Epidemiology College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Guotian Ruan
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Meng Tang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Hailun Xie
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Heyang Zhang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Yizhong Ge
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiangrui Li
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Kangping Zhang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Ming Yang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Qinqin Li
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Liaocheng University, Liaocheng, China
| | - Xiaoyue Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Shiqi Lin
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
| | - Yu Xu
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hongxia Xu
- Department of Nutrition, Daping Hospital & Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Kunhua Wang
- Yunnan University, Kunming, China.,General surgery clinical medical center of Yunnan province, Kunming, China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University, Changchun, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
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5
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Ulloque-Badaracco JR, Mosquera-Rojas MD, Hernandez-Bustamante EA, Alarcón-Braga EA, Herrera-Añazco P, Benites-Zapata VA. Prognostic value of albumin-to-globulin ratio in COVID-19 patients: A systematic review and meta-analysis. Heliyon 2022; 8:e09457. [PMID: 35601226 PMCID: PMC9113764 DOI: 10.1016/j.heliyon.2022.e09457] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/21/2022] [Accepted: 05/12/2022] [Indexed: 12/11/2022] Open
Abstract
Background and aims The albumin-to-globulin ratio (AGR) has been used to predict severity and mortality in infectious diseases. The aim of this study is to evaluate the prognostic value of the AGR in COVID-19 patients. Methods A systematic review and meta-analysis were conducted. We included observational studies assessing the association between the AGR values upon hospital admission and severity or all-cause mortality in COVID-19 patients. In the meta-analyses we used random effect models. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The effect measures were expressed as mean difference (MD) and their 95% confidence intervals (CI). We performed Egger's test and funnel plots to assess the publication bias. Results The included studies had a total of 11356 patients corresponding to 31 cohort studies. Severe COVID-19 patients had lower AGR values than non-severe COVID-19 patients (mean difference (MD), −0.27; 95% IC, −0.32 to −0.22; p < 0.001; I2 = 88%). Non-survivor patients with COVID-19 had lower AGR values than survivor patients (MD, −0.29; 95% IC, −0.35 to −0.24; p < 0.001; I2 = 79%). In the sensitivity analysis, we only included studies with low risk of bias, which decreased the heterogeneity for both outcomes (severity, I2 = 20%; mortality, I2 = 5%). Conclusions Low AGR values upon hospital admission were found in COVID-19 patients with a worse prognosis.
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Affiliation(s)
- Juan R Ulloque-Badaracco
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Melany D Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Enrique A Hernandez-Bustamante
- Sociedad Cientifica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru.,Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Esteban A Alarcón-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Percy Herrera-Añazco
- Universidad Privada San Juan Bautista, Lima, Peru.,Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru
| | - Vicente A Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
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Wang Y, Li C, Wang W, Wang J, Li J, Qian S, Cai C, Liu Y. Serum Albumin to Globulin Ratio is Associated with the Presence and Severity of Inflammatory Bowel Disease. J Inflamm Res 2022; 15:1907-1920. [PMID: 35313674 PMCID: PMC8933625 DOI: 10.2147/jir.s347161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/15/2022] [Indexed: 12/20/2022] Open
Affiliation(s)
- Yanyan Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Chengyong Li
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Weiyi Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Jiajia Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Jinhui Li
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Shuangjie Qian
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Chao Cai
- Department of Infectious Disease, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory for Accurate Diagnosis and Treatment of Chronic Liver Disease, Hepatology Institute of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
- Chao Cai, Department of Infectious Disease, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory for Accurate Diagnosis and Treatment of Chronic Liver Disease, Hepatology Institute of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China, Tel +8613506662567, Email
| | - Yuntao Liu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
- Correspondence: Yuntao Liu, Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China, Tel +8657755579362, Email
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7
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Ma Y, Shang K, Wu S, Wang J, Cao B. The Prognostic Value of Albumin-Globulin Ratio and Eosinophil-Neutrophil Ratio in Patients with Advanced Tumors Undergoing Treatment with PD-1/PD-L1 Inhibitors. Nutr Cancer 2022; 74:2815-2828. [PMID: 35102801 DOI: 10.1080/01635581.2022.2032764] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We investigated the prognostic value of peripheral serum biomarkers, including albumin-globulin ratio (AGR) and eosinophil-neutrophil ratio (ENR), in patients with advanced tumors treated with PD-1/PD-L1 inhibitors. We also retrospectively analyzed the clinical efficacy of PD-1/PD-L1 inhibition in 95 patients with advanced tumors treated at our center. The prognostic value of baseline AGR, baseline ENR, and baseline neutrophil-lymphocyte ratio (NLR) in the serum were evaluated. We also developed a risk scoring tool to stratify patients based on their prognosis. Univariate Cox regression analysis revealed that age, NLR, Eastern Cooperative Oncology Group (ECOG) performance status (PS), platelet-neutrophil ratio (PLR), ENR, AGR, lactate dehydrogenase levels, treatment line, and treatment type were correlated with progression-free survival (PFS). Multivariate Cox regression analysis showed that age, AGR, ENR, and treatment type were independent prognostic factors for PFS. Patients in the low-risk group had significantly longer PFS than those in the high-risk group. The nomogram concordance index (C-index) was 0.716. Patients with a decrease in AGR of over 20% after the first and second treatment cycles had significantly worse PFS than those without decreased AGR. These findings suggest that baseline AGR and ENR may be useful prognostic biomarkers for patients with advanced tumors treated with PD-1/PD-L1 inhibitors.
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Affiliation(s)
- Yan Ma
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
| | - Kun Shang
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
| | - Shanshan Wu
- Department of Clinical Epidemiology and EBM, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
| | - Jing Wang
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
| | - Bangwei Cao
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
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8
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Zhang J, Wang T, Fang Y, Wang M, Liu W, Zhao J, Wang B, Wu Z, Lv Y, Wu R. Clinical Significance of Serum Albumin/Globulin Ratio in Patients With Pyogenic Liver Abscess. Front Surg 2021; 8:677799. [PMID: 34917645 PMCID: PMC8669143 DOI: 10.3389/fsurg.2021.677799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 11/09/2021] [Indexed: 12/30/2022] Open
Abstract
Pyogenic liver abscess (PLA) remains a significant challenge for modern clinicians. Serum albumin/globulin ratio (AGR) can reflect the progress of many diseases. However, the clinical significance of AGR in PLA has not been evaluated. The aim of this study was to explore the effect of AGR on the clinical characteristic and prognosis in PLA patients. This retrospective study included 392 PLA patients who admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January, 2007 to December, 2016. The medical records on admission were collected. Compared with the healthy controls and the patients with extraperitoneal infection or non-infectious liver disease, PLA patients had lower levels of AGR. The mean level of AGR in PLA patients was 1.02 ± 0.25. There were 179 (45.4%) patients with AGR > 1.02 and 213 (54.6%) patients with AGR ≤ 1.02. The baseline data and treatment plans of PLA patients with high or low AGR were comparative. However, PLA patients with a low AGR had higher body temperature, leukocytes and neutrophils, lower hemoglobin, poorer liver and coagulation function, larger abscess diameter, higher positive rate of pus culture and proportion of Escherichia coli, and were more susceptible to multiple bacteria. Moreover, PLA patients with a low AGR had more complications, including systemic inflammatory response syndrome (SIRS), peritoneal effusion and pleural effusion. And it also needs longer time for temperature normalization and hospital stay. In conclusion, PLA patients have lower AGR and lower AGR is associated with worse clinical manifestations, more complications and poorer prognosis. Thus, monitoring of AGR is of great clinical significance for evaluating the progress of PLA patients.
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Affiliation(s)
- Jia Zhang
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tao Wang
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Fang
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mengzhou Wang
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wuming Liu
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Junzhou Zhao
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bo Wang
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zheng Wu
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Lv
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Rongqian Wu
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Pan XL, Liao ZL, Yao H, Yan WJ, Wen DY, Wang Y, Li ZL. Prognostic value of ground glass opacity on computed tomography in pathological stage I pulmonary adenocarcinoma: A meta-analysis. World J Clin Cases 2021; 9:10222-10232. [PMID: 34904092 PMCID: PMC8638064 DOI: 10.12998/wjcc.v9.i33.10222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/18/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The clinical role of ground glass opacity (GGO) on computed tomography (CT) in stage I pulmonary adenocarcinoma patients currently remains unclear.
AIM To explore the prognostic value of GGO on CT in lung adenocarcinoma patients who were pathologically diagnosed with tumor-node-metastasis stage I.
METHODS A comprehensive and systematic search was conducted through the PubMed, EMBASE and Web of Science databases up to April 3, 2021. The hazard ratio (HR) and corresponding 95% confidence interval (CI) were combined to assess the association between the presence of GGO and prognosis, representing overall survival and disease-free survival. Subgroup analysis based on the ratio of GGO was also conducted. STATA 12.0 software was used for statistical analysis.
RESULTS A total of 12 studies involving 4467 patients were included. The pooled results indicated that the GGO predicted favorable overall survival (HR = 0.44, 95%CI: 0.34-0.59, P < 0.001) and disease-free survival (HR = 0.35, 95%CI: 0.18-0.70, P = 0.003). Subgroup analysis based on the ratio of GGO further demonstrated that the proportion of GGO was a good prognostic indicator in pathological stage I pulmonary adenocarcinoma patients, and patients with a higher ratio of GGO showed better prognosis than patients with a lower GGO ratio did.
CONCLUSION This meta-analysis manifested that the presence of GGO on CT predicted favorable prognosis in tumor-node-metastasis stage I lung adenocarcinoma. Patients with a higher GGO ratio were more likely to have a better prognosis than patients with a lower GGO ratio.
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Affiliation(s)
- Xue-Lin Pan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Zi-Ling Liao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hui Yao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wei-Jie Yan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - De-Ying Wen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yan Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Zhen-Lin Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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10
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Xu S, Song L, Liu X. Prognostic Value of Pretreatment Glasgow Prognostic Score/Modified Glasgow Prognostic Score in Ovarian Cancer: A Systematic Review and Meta-Analysis. Nutr Cancer 2021; 74:1968-1975. [PMID: 34549675 DOI: 10.1080/01635581.2021.1980591] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
To explore prognostic value of pretreatment Glasgow prognostic score (GPS) and modified Glasgow prognostic score (mGPS) in ovarian cancer patients. The PubMed, EMBASE (via OVID), and Web of Science databases were comprehensively searched for eligible studies. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to evaluate the association of pretreatment GPS/mGPS with overall survival (OS) and progression-free survival (PFS) of ovarian cancer patients. STATA 12.0 version software was applied for statistical analysis. A total of eight retrospective studies involving 2260 were included into this systematic review and meta-analysis. The pooled results indicated that patients with elevated pretreatment GPS or mGPS had poorer OS (HR = 1.62, 95% CI: 1.38-1.91, P<.001) and PFS (HR = 1.40, 95% CI: 1.02-1.93, P = .039) than patients with pretreatment GPS or mGPS 0. Subgroup analysis based on the type of score (GPS or mGPS) and tumor stage for OS were also performed and the results were consistent with above findings. Pretreatment GPS/mGPS might serve as promising prognostic indexes for ovarian cancer patients. More prospective studies with high-quality are needed to verify our findings.
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Affiliation(s)
- Siyu Xu
- Operation Management Office, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Lei Song
- Medical Insurance Office, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaoshi Liu
- Department of Gynecology and Obstetrics, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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11
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Wang Y, Li J, Chang S, Dong Y, Che G. Risk and Influencing Factors for Subsequent Primary Lung Cancer After Treatment of Breast Cancer: A Systematic Review and Two Meta-Analyses Based on Four Million Cases. J Thorac Oncol 2021; 16:1893-1908. [PMID: 34256110 DOI: 10.1016/j.jtho.2021.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/03/2021] [Accepted: 07/04/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION To compare the risk of developing lung cancer between patients with breast cancer and the general population and explore the risk factors for the development of primary lung cancer after treatment for breast cancer. METHODS The PubMed, EMBASE, and Web of Science databases were searched from the establishment date to October 11, 2020. Two separate meta-analyses were performed: one focused on studies reporting the risk of subsequent lung cancer after breast cancer and one focused on studies exploring the risk factors for subsequent lung cancer in patients with breast cancer. The standardized incidence ratios with 95% confidence intervals were combined to compare the risk of developing lung cancer between patients with breast cancer and the general population. The relative risks (RRs) or ORs with 95% confidence intervals were combined to assess the association of clinicopathological parameters with the risk of developing lung cancer after breast cancer. All statistical analyses were conducted by STATA 12.0. RESULTS A total of 15 studies involving 1,161,979 patients were eventually included in the first meta-analysis, and the pooled results indicated that female patients with breast cancer revealed a significantly higher risk of developing subsequent lung cancer (standardized incidence ratio = 1.25, p < 0.001). In addition, a total of 22 articles involving 3,090,620 patients were included in the second meta-analysis. The pooled results indicated that smoking (OR = 9.73, p < 0.001) and radiotherapy (RR = 1.40, p < 0.001) were risk factors for developing subsequent lung cancer in patients with breast cancer, and chemotherapy (RR = 0.69, p = 0.002), positive estrogen receptor status (RR = 0.93, p = 0.014) and positive progesterone receptor status (RR = 0.86, p < 0.001) were protective factors. Meanwhile, subgroup analysis based on the relative position of the breast and lung cancers (ipsilateral versus contralateral) was conducted, which indicated that radiotherapy only increased the risk of ipsilateral lung cancer in patients with breast cancer (RR = 1.27, p = 0.001). CONCLUSIONS Patients with breast cancer are more likely to develop lung cancer than the general population, and the risk of developing primary lung cancer after breast cancer is affected by smoking, radiotherapy, chemotherapy, estrogen receptor status and progesterone receptor status.
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Affiliation(s)
- Yan Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jialong Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Shuai Chang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yingxian Dong
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
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12
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Jiang H, Deng W, Zhou J, Ren G, Cai X, Li S, Hu B, Li C, Shi Y, Zhang N, Zheng Y, Chen Y, Jiang Q, Zhou Y. Machine learning algorithms to predict the 1 year unfavourable prognosis for advanced schistosomiasis. Int J Parasitol 2021; 51:959-965. [PMID: 33891933 DOI: 10.1016/j.ijpara.2021.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 12/10/2022]
Abstract
Short-term prognosis of advanced schistosomiasis has not been well studied. We aimed to construct prognostic models using machine learning algorithms and to identify the most important predictors by utilising routinely available data under the government medical assistance programme. An established database of advanced schistosomiasis in Hunan, China was utilised for analysis. A total of 9541 patients for the period from January 2008 to December 2018 were enrolled in this study. Candidate predictors were selected from demographics, clinical features, medical examinations and test results. We applied five machine learning algorithms to construct 1 year prognostic models: logistic regression (LR), decision tree (DT), random forest (RF), artificial neural network (ANN) and extreme gradient boosting (XGBoost). An area under the receiver operating characteristic curve (AUC) was used to evaluate the model performance. The important predictors of the optimal model for unfavourable prognosis within 1 year were identified and ranked. There were 1249 (13.1%) cases having unfavourable prognoses within 1 year of discharge. The mean age of all participants was 61.94 years, of whom 70.9% were male. In general, XGBoost showed the best predictive performance with the highest AUC (0.846; 95% confidence interval (CI): 0.821, 0.871), compared with LR (0.798; 95% CI: 0.770, 0.827), DT (0.766; 95% CI: 0.733, 0.800), RF (0.823; 95% CI: 0.796, 0.851), and ANN (0.806; 95% CI: 0.778, 0.835). Five most important predictors identified by XGBoost were ascitic fluid volume, haemoglobin (HB), total bilirubin (TB), albumin (ALB), and platelets (PT). We proposed XGBoost as the best algorithm for the evaluation of a 1 year prognosis of advanced schistosomiasis. It is considered to be a simple and useful tool for the short-term prediction of an unfavourable prognosis for advanced schistosomiasis in clinical settings.
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Affiliation(s)
- Honglin Jiang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Weicheng Deng
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Jie Zhou
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Guanghui Ren
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Xinting Cai
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Shengming Li
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Benjiao Hu
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Chunlin Li
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Ying Shi
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Na Zhang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Yingyan Zheng
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada
| | - Qingwu Jiang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Yibiao Zhou
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China.
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Park EJ, Kim SN, Yoon C, Cho JW, Lee GH, Kim DW, Park J, Choi I, Lee SH, Song J, Lim HJ, Kang MS, Lee HS. Repeated intratracheal instillation of zinc oxide nanoparticles induced pulmonary damage and a systemic inflammatory response in cynomolgus monkeys. Nanotoxicology 2021; 15:621-635. [PMID: 33870832 DOI: 10.1080/17435390.2021.1905899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Recently, some researchers have demonstrated that inhaled zinc oxide nanoparticles (ZnONPs) induce an acute systemic inflammatory response in workers. Considering nonhuman primates are preferably considered an animal model for translational research due to their proven similarity with humans in terms of genetics and physiology, we intratracheally instilled ZnONPs to cynomolgus monkey for 14 days and identified the toxic mechanism and bioaccumulation. ZnONPs were rapidly ionized or aggregated in a simulated pulmonary fluid, and they attracted neutrophils to the lungs and increased the pulmonary level of inflammatory mediators. Additionally, thickened alveolar walls, fibrin clots, and hemorrhages were observed in the lungs of the monkeys instilled with the higher dose accompanied by cell debris in the alveolar ducts and alveoli. Dark-field microscopy images revealed translocation of ZnONPs into other tissues accompanied by an increase in the relative weight of livers to body weight. In addition, when instilled at the higher dose, the albumin/globulin ratio notably decreased compared to the control, whereas the C-reactive protein (CRP) level was significantly elevated. ZnONPs also clearly induced apoptotic cell death in a 24 h exposure to alveolar macrophages. Taken together, part of inhaled ZnONPs may be ionized in the lung, resulting in acute toxic effects, including cell death and tissue damage, and the rest may move to other tissues in the form of particles, causing a systemic inflammatory response. Based on the proven evidence among workers, we also suggest that the CRP level can be recommended as a biomarker for ZnONPs-induced adverse health effects.
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Affiliation(s)
- Eun-Jung Park
- East-West Medical Science Research Institute, Kyung Hee Medical Science Research Institute, Kyung Hee University, Seoul, Republic of Korea.,Human Health and Environmental Toxins Research Center, Kyung Hee Medical Science Research Institute, Kyung Hee University, Seoul, Republic of Korea.,Department of Biomedical Science and Technology, Graduate school, Kyung Hee University, Seoul, South Korea
| | - Soo Nam Kim
- Jeonbuk Branch Institute, Korea Institute of Toxicology, Jeongeup, Republic of Korea.,Bio-Health Convergence Institute GLP Lab, Korea Testing Certification Institute, Cheongju, Republic of Korea
| | - Cheolho Yoon
- Ochang Center, Korea Basic Science Institute, Seoul, South Korea
| | - Jae-Woo Cho
- Jeonbuk Branch Institute, Korea Institute of Toxicology, Jeongeup, Republic of Korea.,Toxicologic Pathology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Gwang-Hee Lee
- School of Civil, Environmental, and Architectural Engineering, Korea University, Seoul, South Korea
| | - Dong-Wan Kim
- School of Civil, Environmental, and Architectural Engineering, Korea University, Seoul, South Korea
| | - Junhee Park
- Department of Life Science, University of Seoul, Seoul, South Korea
| | - Inhee Choi
- Department of Life Science, University of Seoul, Seoul, South Korea
| | - Seung Hyeun Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jeongah Song
- Jeonbuk Branch Institute, Korea Institute of Toxicology, Jeongeup, Republic of Korea
| | - Hyun-Ji Lim
- Department of Biomedical Science and Technology, Graduate school, Kyung Hee University, Seoul, South Korea
| | - Min-Sung Kang
- Department of Biomedical Science and Technology, Graduate school, Kyung Hee University, Seoul, South Korea.,Jeonbuk Branch Institute, Korea Institute of Toxicology, Jeongeup, Republic of Korea
| | - Hong-Soo Lee
- Jeonbuk Branch Institute, Korea Institute of Toxicology, Jeongeup, Republic of Korea
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Yao L, Luo J, Liu L, Wu Q, Zhou R, Li L, Zhang C. Risk factors for postoperative pneumonia and prognosis in lung cancer patients after surgery: A retrospective study. Medicine (Baltimore) 2021; 100:e25295. [PMID: 33787617 PMCID: PMC8021381 DOI: 10.1097/md.0000000000025295] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 03/07/2021] [Indexed: 01/04/2023] Open
Abstract
Postoperative pneumonia (POP) is one of the most frequent complications following lung surgery. The aim of this study was to identify the risk factors for developing POP and the prognostic factors in lung cancer patients after lung resection.We performed a retrospective review of 726 patients who underwent surgery for stages I-III lung cancer at a single institution between August 2017 and July 2018 by conducting logistic regression analysis of the risk factors for POP. The Cox risk model was used to analyze the factors influencing the survival of patients with lung cancer.We identified 112 patients with POP. Important risk factors for POP included smoking (odds ratio [OR], 2.672; 95% confidence interval [CI], 1.586-4.503; P < .001), diffusing capacity for carbon monoxide (DLCO) (40-59 vs ≥80%, 4.328; 95% CI, 1.976-9.481; P < .001, <40 vs ≥80%, 4.725; 95% CI, 1.352-16.514; P = .015), and the acute physiology and chronic health evaluation (APACHE) II score (OR, 2.304; 95% CI, 1.382-3.842; P = .001). In the Cox risk model, we observed that age (hazard ratios (HR), 1.633; 95% CI, 1.062-2.513; P = .026), smoking (HR, 1.670; 95% CI, 1.027-2.716; P = .039), POP (HR, 1.637; 95% CI, 1.030-2.600; P = .037), etc were predictor variables for patient survival among the factors examined in this study.The risk factors for POP and the predictive factors affecting overall survival (OS) should be taken into account for effective management of patients with lung cancer undergoing surgery.
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15
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Zhang CC, Zhang CW, Xing H, Wang Y, Liang L, Diao YK, Chen TH, Lau WY, Bie P, Chen ZY, Yang T. Preoperative Inversed Albumin-to-Globulin Ratio Predicts Worse Oncologic Prognosis Following Curative Hepatectomy for Hepatocellular Carcinoma. Cancer Manag Res 2020; 12:9929-9939. [PMID: 33116850 PMCID: PMC7567562 DOI: 10.2147/cmar.s275307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/16/2020] [Indexed: 01/27/2023] Open
Abstract
Background A normal albumin-to-globulin ratio (NAGR) in serum is greater than 1. Inversed albumin-to-globulin ratio (IAGR < 1) indicates poor synthetic liver function or malnutrition. The aim of this study is to evaluate whether preoperative IAGR was associated with worse oncologic survival after hepatectomy for hepatocellular carcinoma (HCC). Patients and Methods Patients who underwent curative hepatectomy for HCC between 2009 and 2016 in four centers were divided into the IAGR and NAGR groups based on their preoperative levels, and their clinical characteristics and long-term survival outcomes were compared. Univariable and multivariable Cox regression analyses were performed to identify risk factors of overall survival (OS) and recurrence-free survival (RFS). Results Of 693 enrolled patients, 136 (19.6%) were in the IAGR group. Their 5-year OS and RFS rates were 31.6% and 21.3%, respectively, which were significantly worse than the NAGR group (43.4% and 28.7%, both P < 0.001). The area under the receiver operating characteristic curves in predicting 5-year OS and RFS using the albumin-to-globulin ratio were 0.68 and 0.67, respectively, which were significantly higher than albumin (0.60 and 0.59), globulin (0.56 and 0.57), Child-Pugh grading (0.61 and 0.60), Model for End-Stage Liver Disease Score (0.59 and 0.58), and Albumin-Bilirubin grading (0.64 and 0.63). Multivariable analyses identified that preoperative IAGR was independently associated with worse OS (HR: 1.444, 95% confidence interval (CI): 1.125–1.854, P = 0.004) and RFS (HR: 1.463, 95% CI: 1.159–1.848, P = 0.001). Conclusion Preoperative IAGR was useful in predicting worse OS and RFS in patients who underwent curative hepatectomy for HCC.
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Affiliation(s)
- Cheng-Cheng Zhang
- Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Cheng-Wu Zhang
- Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China
| | - Hao Xing
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China
| | - Yu Wang
- Department of Hepatobiliary Surgery, Chongqing University Cancer Hospital, Chongqing, China
| | - Lei Liang
- Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China.,Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, China
| | - Yong-Kang Diao
- Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China.,Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, China
| | - Ting-Hao Chen
- Department of General Surgery, Ziyang First People's Hospital, Sichuan, China
| | - Wan Yee Lau
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China.,Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Ping Bie
- Department of Hepatobiliary, The Third Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Zhi-Yu Chen
- Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tian Yang
- Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China
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16
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Liu J, Gan Y, Song H, Zhu K, Zhang Q. The predictive value of the preoperative fibrinogen-albumin ratio on the postoperative prognosis of renal cell carcinoma. Transl Androl Urol 2020; 9:1053-1061. [PMID: 32676389 PMCID: PMC7354337 DOI: 10.21037/tau-19-873] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Urologists urgently need a simple, effective, accurate clinical biomarker to identify renal cell carcinoma (RCC) patients with poor prognosis and those with a high risk of recurrence as early as possible. Therefore, we investigated the prognostic value of the preoperative fibrinogen-albumin ratio (FAR) in patients with RCC. Methods We retrospectively analyzed data from 279 cases of renal cancer admitted to the First Hospital of Peking University from 2010 to 2012. The best cutoff value of the FAR was obtained using receiver operating characteristic (ROC) curve analysis, and patients were divided into high- and low-FAR groups. The correlation between the preoperative FAR and clinicopathological features was analyzed by χ2 test. Log-rank test and Cox proportional hazard regression model were used to evaluate the predictive value of clinicopathological parameters for overall survival (OS). Results The best cutoff value for the FAR was 0.116. A FAR >0.116 was associated with higher Fuhrman grade (P<0.0001) and later pathological T stage (P<0.0001). Patients with a high FAR (>0.116) had worse OS [hazard ratio (HR) 10.497, 95% confidence interval (CI): 3.263–33.766, P<0.0001]. In multivariate analysis, the FAR was an independent risk factor for OS (HR 5.047, 95% CI: 2.109–12.076, P=0.003). Moreover, in Fuhrman grade I–II patients, the FAR could distinguish patients with worse prognosis (P<0.0001). Conclusions The preoperative FAR is an independent prognostic factor of OS in renal cancer patients. A FAR >0.116 was significantly related to decreased survival in renal cancer patients.
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Affiliation(s)
- Jun Liu
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, Beijing 100034, China.,National Research Center for Genitourinary Oncology, Beijing 100034, China.,Peking University Applied Lithotripsy Institute, Peking University, Beijing 100044, China.,Urology and lithotripsy center, Peking University People's Hospital, Beijing 100044, China
| | - Ying Gan
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, Beijing 100034, China.,National Research Center for Genitourinary Oncology, Beijing 100034, China
| | - Haifeng Song
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, Beijing 100034, China.,National Research Center for Genitourinary Oncology, Beijing 100034, China
| | - Kun Zhu
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, Beijing 100034, China.,National Research Center for Genitourinary Oncology, Beijing 100034, China
| | - Qian Zhang
- Department of Urology, Peking University First Hospital, Beijing 100034, China.,Institute of Urology, Peking University, Beijing 100034, China.,National Research Center for Genitourinary Oncology, Beijing 100034, China
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Li J, Wang Y, Wu Y, Li J, Che G. Prognostic Value of Pretreatment Albumin to Globulin Ratio in Lung Cancer: A Meta-Analysis. Nutr Cancer 2020; 73:75-82. [PMID: 32148098 DOI: 10.1080/01635581.2020.1737155] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Jue Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Yan Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Yanming Wu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jialong Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China
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Yalikun K, Tuersun T, Abudula M, Tiheiran M, Fu Q, Yisireyili D, Zhou Q. Serum albumin levels and serum albumin-globulin ratio are associated with poor prognosis in glioblastoma. Transl Cancer Res 2020; 9:1594-1603. [PMID: 35117507 PMCID: PMC8798444 DOI: 10.21037/tcr.2020.01.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/03/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Serum albumin levels (ALB) and albumin-globulin ratio (AGR) are reliable and convenient markers of the nutritional status and inflammation of human body, and ALB has been identified as a prognostic factor in the patients of glioblastoma (GBM). However, no literature has reported the prediction value of AGR for GBM. METHODS In this study we evaluate the serum ALB and AGR levels for GBM. A total of 126 patients with GBM who underwent surgical resection in our institution between 2013 and 2017 were analyzed retrospectively. Clinical information was obtained from electronic medical records. Multiple logistic regression and Cox proportional hazards models were used to assess the prediction value of preoperative ALB and AGR for GBM. RESULTS Preoperative ALB (HR 0.342, 95% CI, 0.123-0.954, P=0.040) and postoperative adjuvant therapy (HR 0.042, 95% CI, 0.005-0.330, P=0.003) were significantly related to progression-free survival (PFS). Cox regression analysis showed the significance of adjuvant therapy (HR 3.579, 95% CI, 2.236-5.729, P<0.001). Preoperative AGR (HR 0.280, 95% CI, 0.103-0.763, P=0.013) and adjuvant therapy (HR 0.156, 95% CI, 0.047-0.513, P=0.002) were showed significance, and Cox regression analysis showed preoperative AGR (HR 1.810, 95% CI, 1.095-2.992, P=0.021) and adjuvant therapy (HR 4.702, 95% CI, 2.841-7.782, P<0.001) were independent predictors of overall survival (OS). CONCLUSIONS The ALB and AGR had significant predictive values for the prognosis of GBM; postoperative adjuvant treatment is also an independent predictor for the prognosis of GBM patients.
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Affiliation(s)
- Kugeluke Yalikun
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Tuerhong Tuersun
- Department of Intensive Care Unit, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Maiaitituersun Abudula
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Maijudan Tiheiran
- Department of Imaging, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Qiang Fu
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Dilimulati Yisireyili
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Qingjiu Zhou
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
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Peng F, Sun L, Chen T, Zhu Y, Zhou W, Li P, Chen Y, Zhuang Y, Huang Q, Long H. Albumin-globulin ratio and mortality in patients on peritoneal dialysis: a retrospective study. BMC Nephrol 2020; 21:51. [PMID: 32059708 PMCID: PMC7023751 DOI: 10.1186/s12882-020-1707-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/28/2020] [Indexed: 01/14/2023] Open
Abstract
Background Albumin-globulin ratio (AGR), a variable based on serum albumin and non-albumin proteins, has been demonstrated as a predictor of mortality in patients with malignant neoplasm. The aim of this study was to evaluate the prognostic value of AGR on peritoneal dialysis (PD) patients. Methods We retrospectively analyzed 602 incident PD patients from January 1st, 2008, to December 31st, 2017, at our center and followed them until December 31st, 2018. Kaplan-Meier curves and multivariate Cox regression models were applied to analyze the association between AGR and all-cause of mortality and cardiovascular mortality. Results The median follow-up time was 32.17 (interquartile range = 32.80) months. During follow-up, 131 (21.8%) patients died, including 57 patients (43.5%) who died due to cardiovascular diseases. Kaplan-Meier curves showed that patients with AGR > 1.26 had better rates of survival than those with AGR ≤ 1.25 (p < 0.001). After adjusting for potential confounders, the lower AGR level was significantly associated with an increased all-cause and cardiovascular mortality [hazard ratio (HR): 1.57, 95% confidence interval (CI): 1.07–2.32, p = 0.022 and HR: 2.01, 95% CI: 1.10–3.69, p = 0.023 respectively]. Conclusions Patients with a low AGR level had an increased all-cause and cardiovascular mortality. AGR may be a useful index in identifying patients on PD at risk for CVD and all-cause of mortality.
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Affiliation(s)
- Fenfen Peng
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Lingzhi Sun
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Ting Chen
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yan Zhu
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Weidong Zhou
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Peilin Li
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yihua Chen
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yiyi Zhuang
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Qianyin Huang
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China.
| | - Haibo Long
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China.
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