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Pinto TAM, Saito HPA, Nourani CL, Ataide EC, Boin IFSF, Lourenco GJ, Lima CSP. Clinicopathological Aspects and Inflammation-Immune Markers in Alcohol and/or Hepatitis C Virus-Induced Hepatocellular Carcinoma Patients Treated With Sorafenib. Gastroenterology Res 2024; 17:23-31. [PMID: 38463146 PMCID: PMC10923249 DOI: 10.14740/gr1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/06/2024] [Indexed: 03/12/2024] Open
Abstract
Background Tyrosine kinase inhibitors have been used to treat hepatocellular carcinoma (HCC), but the outcomes of patients under treatment vary. Since the roles of clinicopathological aspects and markers of chronic inflammation/immune homeostasis in the outcome of HCC patients treated with sorafenib are still unclear, these were the aims of this study. Methods Patients with alcohol-induced and/or hepatitis C virus (HCV)-induced HCC (n = 182) uniformly treated with sorafenib were included in the study. Baseline clinicopathological aspects of patients were computed from the medical records. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII) were obtained from the hematological exam performed before the administration of sorafenib. Overall survival (OS) was analyzed using Kaplan-Meier probabilities, log-rank test, and univariate and multivariate Cox proportional hazard ratio (HR) analyses. Results In multivariate analysis, alpha-foetoprotein (AFP) level and Child-Pugh score were predictors of OS. Patients with AFP levels higher than 157 ng/mL and Child-Pugh B or C had 1.40 (95% confidence interval (CI): 1.03 - 1.91, P = 0.03) and 1.64 (95% CI: 1.07 - 2.52, P = 0.02) more chances of evolving to death than the remaining patients, respectively. NLR, PLR, LMR, SIRI, and SII did not alter the OS of HCC patients. Conclusions AFP level and Child-Pugh score act as independent prognostic factors in patients with alcohol and/or HCV-induced HCC treated with sorafenib, but markers of chronic inflammation/immune homeostasis seem not to alter the outcome of patients with HCC induced by alcohol and/or HCV.
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Affiliation(s)
- Thiago Alexandre Martins Pinto
- Clinical Oncology Service, Department of Anesthesiology, Oncology, and Radiology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Helena Paes Almeida Saito
- Clinical Oncology Service, Department of Anesthesiology, Oncology, and Radiology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Carolina Lopes Nourani
- Clinical Oncology Service, Department of Anesthesiology, Oncology, and Radiology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Elaine Cristina Ataide
- Department of Surgery, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | | | - Gustavo Jacob Lourenco
- Laboratory of Cancer Genetics; School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Carmen Silvia Passos Lima
- Clinical Oncology Service, Department of Anesthesiology, Oncology, and Radiology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
- Laboratory of Cancer Genetics; School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
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Guo Y, Cen K, Yang S, Mai Y, Hong K. Development and validation of an inflammatory response-related signature in triple negative breast cancer for predicting prognosis and immunotherapy. Front Oncol 2023; 13:1175000. [PMID: 37397391 PMCID: PMC10311032 DOI: 10.3389/fonc.2023.1175000] [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: 03/02/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Background Inflammation is one of the most important characteristics of tumor tissue. Signatures based on inflammatory response-related genes (IRGs) can predict prognosis and treatment response in a variety of tumors. However, the clear function of IRGs in the triple negative breast cancer (TNBC) still needs to be explored. Methods IRGs clusters were discovered via consensus clustering, and the prognostic differentially expressed genes (DEGs) across clusters were utilized to develop a signature using a least absolute shrinkage and selection operator (LASSO). Verification analyses were conducted to show the robustness of the signature. The expression of risk genes was identified by RT-qPCR. Lastly, we formulated a nomogram to improve the clinical efficacy of our predictive tool. Results The IRGs signature, comprised of four genes, was developed and was shown to be highly correlated with the prognoses of TNBC patients. In contrast with the performance of the other individual predictors, we discovered that the IRGs signature was remarkably superior. Also, the ImmuneScores were elevated in the low-risk group. The immune cell infiltration showed significant difference between the two groups, as did the expression of immune checkpoints. Conclusion The IRGs signature could act as a biomarker and provide a momentous reference for individual therapy of TNBC.
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Affiliation(s)
- Yangyang Guo
- Department of Thyroid and Breast Surgery, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Kenan Cen
- Department of Geriatrics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China
| | - Shi Yang
- Department of Thyroid and Breast Surgery, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Yifeng Mai
- Department of Geriatrics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China
| | - Kai Hong
- Department of Thyroid and Breast Surgery, Ningbo First Hospital, Ningbo, Zhejiang, China
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Tian BW, Yan LJ, Ding ZN, Liu H, Meng GX, Xue JS, Han CL, Dong ZR, Hong JG, Chen ZQ, Wang DX, Li T. Early alpha-fetoprotein response predicts prognosis of immune checkpoint inhibitor and targeted therapy for hepatocellular carcinoma: a systematic review with meta-analysis. Expert Rev Gastroenterol Hepatol 2023; 17:73-83. [PMID: 36476076 DOI: 10.1080/17474124.2022.2156859] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The prognostic value of alpha-fetoprotein (AFP) response for efficacy of targeted therapy or immune checkpoint inhibitors (ICIs) has not been established. The purpose of this meta-analysis is to elucidate the relationship between AFP response and survival outcomes in hepatocellular carcinoma (HCC) patients who received targeted therapy or ICIs. METHODS The hazard ratio (HR) with 95% confidence interval (CI) was used to evaluate the relationship between AFP response and overall survival (OS)/progression-free survival (PFS). RESULTS Twenty-six articles containing 3056 HCC patients were finally included in the study. The pooled results showed that after targeted therapy or ICIs, patients with decrease in AFP had better prognosis (OS:HR = 0.48, 95%CI:0.40-0.56; PFS:HR = 0.39, 95%CI:0.33-0.46), while patients with increase in AFP had worse prognosis (OS:HR = 2.30, 95%CI:1.82-2.89; PFS:HR = 2.34, 95%CI = 1.69-3.24). Subgroup analysis revealed that compared to AFP decrease >50%, AFP decrease >20% can better predict the prognosis of patients who received targeted therapy (OS:HR = 0.51, 95%CI:0.41-0.62; PFS:HR = 0.39, 95%CI:0.30-0.51) or ICIs treatment (OS:HR = 0.34, 95%CI:0.16-0.71; PFS:HR = 0.22, 95%CI:0.10-0.47), and 8 weeks after targeted therapy may be the appropriate time point for AFP assessment. CONCLUSION AFP decrease >20% within 8 weeks may be the appropriate definition for early AFP response which probably works best in predicting the efficacy of therapy. REGISTRATION The review was not registered.
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Affiliation(s)
- Bao-Wen Tian
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Lun-Jie Yan
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Zi-Niu Ding
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Hui Liu
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Guang-Xiao Meng
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Jun-Shuai Xue
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Cheng-Long Han
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Zhao-Ru Dong
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Jian-Guo Hong
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Zhi-Qiang Chen
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Dong-Xu Wang
- Department of General Surgery, Qilu Hospital, Shandong University, 250012, Jinan, P.R. China
| | - Tao Li
- Department of Hepatobiliary Surgery, the Second Hospital of Shandong University, 250012, Jinan P.R. China
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Song S, Bai M, Li X, Gong S, Yang W, Lei C, Tian H, Si M, Hao X, Guo T. Early Predictive Value of Circulating Biomarkers for Sorafenib in Advanced Hepatocellular Carcinoma. Expert Rev Mol Diagn 2022; 22:361-378. [PMID: 35234564 DOI: 10.1080/14737159.2022.2049248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Sorafenib is currently the first-line therapeutic regimen for patients with advanced hepatocellular carcinoma (HCC). However, many patients did not experience any benefit and suffered extreme adverse events and heavy economic burden. Thus, the early identification of patients who are most likely to benefit from sorafenib is needed. AREAS COVERED This review focused on the clinical application of circulating biomarkers (including conventional biomarkers, immune biomarkers, genetic biomarkers, and some novel biomarkers) in advanced HCC patients treated with sorafenib. An online search on PubMed, Web of Science, Embase, and Cochrane Library was conducted from the inception to Aug 15, 2021. Studies investigating the predictive or prognostic value of these biomarkers were included. EXPERT OPINION The distinction of patients who may benefit from sorafenib treatment is of utmost importance. The predictive roles of circulating biomarkers could solve this problem. Many biomarkers can be obtained by liquid biopsy, which is a less or non-invasive approach. The short half-life of sorafenib could reflect the dynamic changes of tumor progression and monitor the treatment response. Circulating biomarkers obtained from liquid biopsy resulted as a promising assessment method in HCC, allowing for better treatment decisions in the near future.
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Affiliation(s)
- Shaoming Song
- The First Clinical Medical College of Lanzhou University, Lanzhou, China.,Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Mingzhen Bai
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Xiaofei Li
- Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Shiyi Gong
- Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China.,School of Basic Medical Sciences, Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China
| | - Wenwen Yang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China.,School of Basic Medical Sciences, Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China
| | - Caining Lei
- Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China.,School of Basic Medical Sciences, Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China
| | - Hongwei Tian
- The First Clinical Medical College of Lanzhou University, Lanzhou, China.,Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China.,Key Laboratory of Molecular Diagnostics, and Precision Medicine of Surgical Oncology in Gansu Province, Lanzhou, China
| | - Moubo Si
- Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China.,Key Laboratory of Molecular Diagnostics, and Precision Medicine of Surgical Oncology in Gansu Province, Lanzhou, China
| | - Xiangyong Hao
- Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China.,Key Laboratory of Molecular Diagnostics, and Precision Medicine of Surgical Oncology in Gansu Province, Lanzhou, China
| | - Tiankang Guo
- The First Clinical Medical College of Lanzhou University, Lanzhou, China.,Key Laboratory of Molecular Diagnostics, and Precision Medicine of Surgical Oncology in Gansu Province, Lanzhou, China
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Zhu M, Chen L, Kong X, Wang X, Fang Y, Li X, Wang J. The Systemic Inflammation Response Index as an Independent Predictor of Survival in Breast Cancer Patients: A Retrospective Study. Front Mol Biosci 2022; 9:856064. [PMID: 35295846 PMCID: PMC8918696 DOI: 10.3389/fmolb.2022.856064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/08/2022] [Indexed: 11/17/2022] Open
Abstract
There is a close relationship between inflammatory cells and tumors, but the pathways that connect the two remain unclear. This research explores the clinical and prognostic value of the systemic inflammation response index (SIRI) in breast cancer patients. The study included 477 breast cancer patients who underwent neoadjuvant chemotherapy and 308 breast cancer patients who did not in our center between January 1998 and December 2016. Optimal SIRI threshold values were determined using the receiver operating characteristic curve (ROC). Patients were then reclassified as SIRI ≥0.80 group (High SIRI group) and SIRI <0.80 group (Low SIRI group). The outcomes were analyzed by statistical methods. The univariate and multivariate analyses demonstrated that SIRI independently predicted survival in breast cancer. The disease-free survival (DFS) and overall survival (OS) in patients with low SIRI scores were significantly longer in contrast to those with high SIRI scores (41.50 vs. 37.63 months, and 64.57 vs. 58.42 months). Further subgroup analyses revealed that low SIRI score patients who also had either early breast cancer, advanced breast cancer, or different molecular subtypes also possessed longer mean survival time of DFS and OS in contrast to those with high SIRI levels (χ2 = 2.379, p = 0.123, and χ2 = 5.153, p = 0.023; χ2 = 11.080, p = 0.0009 and χ2 = 15.900, p < 0.0001; χ2 = 16.020, p < 0.0001 and χ2 = 22.050, p < 0.0001, respectively). SIRI serves as an easily accessible, replicable, and minimally invasive prognostic tool in breast cancer patients. Lower SIRI scores were predictive of a longer DFS and OS after surgery in breast cancer patients. SIRI may serve as a marker to guide clinical management and prognostication of breast cancer.
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Affiliation(s)
- Mengliu Zhu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Chen
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyu Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Yi Fang, ; Xingrui Li, ; Jing Wang,
| | - Xingrui Li
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Yi Fang, ; Xingrui Li, ; Jing Wang,
| | - Jing Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Yi Fang, ; Xingrui Li, ; Jing Wang,
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Chim ST, Sanfilippo P, O'Brien TJ, Drummond KJ, Monif M. Pretreatment neutrophil-to-lymphocyte/monocyte-to-lymphocyte ratio as prognostic biomarkers in glioma patients. J Neuroimmunol 2021; 361:577754. [PMID: 34700046 DOI: 10.1016/j.jneuroim.2021.577754] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 09/25/2021] [Accepted: 10/16/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To evaluate the ability for pre-treatment NLR and MLR to predict overall survival (OS) and modified Rankin Scale (mRS) and to explore their relationship with clinicopathological parameters. METHODS Retrospective analysis of pretreatment NLR and MLR from 64 glioma patients. RESULTS Higher pretreatment NLR (>4.7) predicted higher mean admission mRS (p < 0.001) and 6-month mRS (p = 0.02). Higher pretreatment MLR (>0.35) was a risk factor for poorer OS in glioma patients (p = 0.024). Higher pretreatment NLR was significantly associated with larger tumor diameter (p = 0.02). CONCLUSION NLR and MLR can serve as prognostic markers to predict functional outcomes and OS in glioma patients.
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Affiliation(s)
- Sher Ting Chim
- Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC 3800, Australia; Melbourne Brain Centre, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3052, Australia; Department of Neurology, Royal Melbourne Hospital, Grattan St, Parkville, VIC 3050, Australia.
| | - Paul Sanfilippo
- Department of Neuroscience, Monash University, Melbourne, VIC 3000, Australia.
| | - Terence J O'Brien
- Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC 3800, Australia; Melbourne Brain Centre, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3052, Australia; Department of Neurology, Alfred Health, Prahran, Melbourne, VIC 3000, Australia; Department of Neuroscience, Monash University, Melbourne, VIC 3000, Australia.
| | - Kate J Drummond
- Department of Neurosurgery, The University of Melbourne, Parkville, VIC 3050, Australia; Department of Neurosurgery, Royal Melbourne Hospital, Parkville, VIC 3050, Australia.
| | - Mastura Monif
- Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC 3800, Australia; Melbourne Brain Centre, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3052, Australia; Department of Neurology, Royal Melbourne Hospital, Grattan St, Parkville, VIC 3050, Australia; Department of Neurology, Alfred Health, Prahran, Melbourne, VIC 3000, Australia; Department of Neuroscience, Monash University, Melbourne, VIC 3000, Australia.
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7
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ŞAN İ, GEMCİOĞLU E, DAVUTOĞLU M, ÇATALBAŞ R, KARABUĞA B, KAPTAN E, ERDEN A, KÜÇÜKŞAHİN O, ATEŞ İ, KARAAHMETOĞLU S, HASANOĞLU İ, İNAN O, ÜNAL BN, ERDEMİR E, KAHRAMAN FA, GÜNER R. Which hematological markers have predictive value as early indicators of severe COVID-19 cases in the emergency department? Turk J Med Sci 2021; 51:2810-2821. [PMID: 33726485 PMCID: PMC10734829 DOI: 10.3906/sag-2008-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 12/13/2021] [Accepted: 03/15/2021] [Indexed: 11/03/2022] Open
Abstract
Background/aim Coronavirus 2019 disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a pandemic infectious disease that causes morbidity and mortality. As a result of high mortality rate among the severe COVID-19 patients, the early detection of the disease stage and early effective interventions are very important in reducing mortality. Hence, it is important to differentiate severe and nonsevere cases from each other. To date, there are no proven diagnostic or prognostic parameters that can be used in this manner. Due to the expensive and not easily accessible tests that are performed for COVID-19, researchers are investigating some parameters that can be easily used. In some recent studies, hematological parameters have been evaluated to see if they can be used as predictive parameters. Materials and methods In the current study, almost all hematological parameters were used, including the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, mean platelet volume to lymphocyte ratio, mean platelet volume to platelet ratio, plateletcrit, and D-dimer/fibrinogen ratio, neutrophil/lymphocyte/platelet scoring system, and systemic immune-inflammation index. A total of 750 patients, who were admitted to Ankara City Hospital due to COVID-19, were evaluated in this study. The patients were classified into 2 groups according to their diagnosis (confirmed or probable) and into 2 groups according to the stage of the disease (nonsevere or severe). Results The values of the combinations of inflammatory markers and other hematological parameters in all of the patients with severe COVID-19 were calculated, and the predicted values of these parameters were compared. According to results of the study, nearly all of the hematological parameters could be used as potential diagnostic biomarkers for subsequent analysis, because the area under the curve (AUC) was higher than 0.50, especially for the DFR and NLR, which had the highest AUC among the parameters. Conclusion Our findings indicate that, the parameters those enhanced from complete blood count, which is a simple laboratory test, can help to identify and classify COVID-19 patients into non-severe to severe groups.
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Affiliation(s)
- İshak ŞAN
- Department of Emergency, Faculty of Medicine, University of Health Sciences, Ankara,
Turkey
| | - Emin GEMCİOĞLU
- Department of Internal Medicine, Ankara City Hospital, Ankara,
Turkey
| | - Mehmet DAVUTOĞLU
- Department of Internal Medicine, Faculty of Medicine, Yıldırım Beyazıt University, Ankara,
Turkey
| | - Ramis ÇATALBAŞ
- Department of Internal Medicine, Faculty of Medicine, Yıldırım Beyazıt University, Ankara,
Turkey
| | - Berkan KARABUĞA
- Department of Internal Medicine, Faculty of Medicine, Yıldırım Beyazıt University, Ankara,
Turkey
| | - Enes KAPTAN
- Department of Internal Medicine, Faculty of Medicine, Yıldırım Beyazıt University, Ankara,
Turkey
| | - Abdulsamet ERDEN
- Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara,
Turkey
| | - Orhan KÜÇÜKŞAHİN
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Yıldırım Beyazıt University, Ankara,
Turkey
| | - İhsan ATEŞ
- Department of Internal Medicine, Ankara City Hospital, Ankara,
Turkey
| | | | - İmran HASANOĞLU
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara,
Turkey
| | - Osman İNAN
- Department of Internal Medicine, Ankara City Hospital, Ankara,
Turkey
| | - Büşra Nur ÜNAL
- Department of Internal Medicine, Ankara City Hospital, Ankara,
Turkey
| | - Ecem ERDEMİR
- Department of Internal Medicine, Ankara City Hospital, Ankara,
Turkey
| | - Fatih Ahmet KAHRAMAN
- Department of Emergency, Faculty of Medicine, Yıldırım Beyazıt University, Ankara,
Turkey
| | - Rahmet GÜNER
- Department of Emergency, Faculty of Medicine, University of Health Sciences, Ankara,
Turkey
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8
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Rabah H, Itani A, Chalhoub M. Leukocytes in Critical Patients With Asthma Exacerbation. Cureus 2021; 13:e20520. [PMID: 35070555 PMCID: PMC8766224 DOI: 10.7759/cureus.20520] [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] [Accepted: 12/19/2021] [Indexed: 11/05/2022] Open
Abstract
Background Asthma exacerbations, defined as acute or subacute progressive worsening of airway spasm, are a significant cause of disease morbidity. Risk factors for exacerbation include sex, age, race, socioeconomic status, baseline lung function, smoking history, and exposure to respiratory viruses. It is believed that white cells play an essential role in the pathogenesis of such attacks; however, the current understanding of the relationship between cell lines during an asthma attack is minimal. Methods This report represents a retrospective study for patients admitted to ICU for asthma exacerbations. The Medical Information Mart for Intensive Care iii (MIMIC iii) version 1.4 database was used to identify patients admitted for asthma exacerbations. The demographics, laboratory data gathered in addition, to clinical variables and outcomes were determined. Results The length of stay increased with the increase in WBC (p = 0.001). Intubated patients had an increased white blood cell (WBC) count when compared with non-intubated patients (p-value 0.009). In addition, patients with normal basophil counts on presentation were less likely to need intubation than those presenting with low basophils (p-value 0.015, adjusted odds ratio = 0.074, CI [0.009-0.620]) and those presenting with basophilia (p-value 0.001, adjusted odds ratio = 0.025, CI [0.003-0.225]). Furthermore, prolonged intubation (for three days or more) was positively correlated with eosinophil counts. On the other hand, there was no statistically significant association between the length of ICU and the patient's age, smoking status, or gender (p-values 0.611; 0.761; and 0.201, respectively). Conclusion Asthma exacerbation is a disease of heterogeneous pathophysiology. The leukocyte count is associated with the length of stay and the need for mechanical ventilation.
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Affiliation(s)
- Hussein Rabah
- Internal Medicine, Staten Island University Hospital, New York, USA
| | - Ahmad Itani
- Pulmonary and Critical Care Medicine, Staten Island University Hospital, New York, USA
| | - Michel Chalhoub
- Pulmonary and Critical Care Medicine, Staten Island University Hospital, New York, USA
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9
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Liu W, Zhang F, Quan B, Li M, Lu S, Li J, Chen R, Yin X. The Prognostic Value of the Albumin to Gamma-Glutamyltransferase Ratio in Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation. DISEASE MARKERS 2021; 2021:3514827. [PMID: 34840628 PMCID: PMC8626189 DOI: 10.1155/2021/3514827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022]
Abstract
Albumin to gamma-glutamyltransferase ratio (AGR) is a newly developed biomarker for the prediction of patients' prognosis in solid tumors. The purpose of the study was to establish a novel AGR-based nomogram to predict tumor prognosis in patients with early-stage HCC undergoing radiofrequency ablation (RFA). 394 hepatocellular carcinoma (HCC) patients who had received RFA as initial treatment were classified into the training cohort and validation cohort. Independent prognostic factors were identified by univariate and multivariate analyses. The value of AGR was evaluated by the concordance index (C-index), receiver operating characteristic (ROC) curves, and likelihood ratio tests (LAT). Logistic regression and nomogram were performed to establish the pretreatment scoring model based on the clinical variables. As a result, AGR = 0.63 was identified as the best cutoff value to predict overall survival (OS) in the training cohort. According to the results of multivariate analysis, AGR was an independent indicator for OS and recurrence-free survival (RFS). In both training cohort and validation cohort, the high-AGR group showed better RFS and OS than the low-AGR group. What is more, the C-index, area under the ROC curves, and LAT χ 2 values suggested that AGR outperformed the Child-Pugh (CP) grade and albumin-bilirubin (ALBI) grade in terms of predicting OS. The AGR, AKP, and tumor size were used to establish the OS nomogram. Besides, the results of Hosmer-Lemeshow test and calibration curve analysis displayed that both nomograms in the training and validation cohorts performed well in terms of calibration. Therefore, the AGR-based nomogram can predict the postoperative prognosis of early HCC patients undergoing RFA.
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Affiliation(s)
- Wenfeng Liu
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Feng Zhang
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Bing Quan
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Miao Li
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Shenxin Lu
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Jinghuan Li
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Rongxin Chen
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
| | - Xin Yin
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
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10
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Wang TC, An TZ, Li JX, Pang PF. Systemic Inflammation Response Index is a Prognostic Risk Factor in Patients with Hepatocellular Carcinoma Undergoing TACE. Risk Manag Healthc Policy 2021; 14:2589-2600. [PMID: 34188570 PMCID: PMC8232961 DOI: 10.2147/rmhp.s316740] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022] Open
Abstract
Background Mounting evidence has shown that systemic inflammation response index (SIRI), a novel prognostic biomarker based on peripheral lymphocyte, neutrophil and monocyte counts, is associated with poor prognosis for several tumors. However, the prognostic value of SIRI in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) is elusive. Herein, we aimed to evaluate the correlation between SIRI and clinical outcomes in these patients. Methods A total of 194 consecutive patients who underwent TACE were included in this study. Patients were stratified into high and low SIRI groups based on the cut-off value using receiver operating characteristic (ROC) analysis. Independent risk factors for tumor response were analyzed using forward stepwise logistic regression. A one-to-one propensity score matching (PSM) was conducted to compare progression-free survival (PFS) and overall survival (OS) between low and high SIRI patients. The discriminatory power of the combination of number of tumors and SIRI in predicting initial TACE response was evaluated by ROC analysis. Results Patients were divided into high SIRI (> 0.88) and low SIRI (≤ 0.88) groups. High SIRI (p = 0.003) and more than three tumors (p = 0.002) were significantly related to poorer tumor response. Moreover, the low SIRI group had longer PFS and OS than the high SIRI group (both P < 0.05) before and after PSM. Combination of SIRI and number of tumors can improve the predictive ability to predict initial TACE response with an area under the curve (AUC) of 0.678. Conclusion Pretreatment peripheral blood SIRI was found to be an independent predictor of tumor response and clinical outcomes in patients with HCC undergoing TACE. Patients with high SIRI may have a poor prognosis.
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Affiliation(s)
- Tian-Cheng Wang
- Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong, People's Republic of China.,Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Tian-Zhi An
- Department of Interventional Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Jun-Xiang Li
- Department of Interventional Radiology, The Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Peng-Fei Pang
- Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong, People's Republic of China
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11
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Jakubowska K, Koda M, Grudzińska M, Kańczuga-Koda L, Famulski W. Monocyte-to-lymphocyte ratio as a prognostic factor in peripheral whole blood samples of colorectal cancer patients. World J Gastroenterol 2020; 26:4639-4655. [PMID: 32884222 PMCID: PMC7445871 DOI: 10.3748/wjg.v26.i31.4639] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/09/2020] [Accepted: 07/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer is the third most common malignancy worldwide. Therefore, it is critically important to identify new useful markers that can be easily obtained in routine practice. Inflammation is a crucial issue in the pathogenesis and development of cancer. AIM To evaluate the prognostic value of absolute monocyte count, monocyte to lymphocyte ratio (MLR), the combination of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (NLR-PLR), and combined platelet and neutrophil-to-lymphocyte ratio (PLT-NLR) in peripheral blood samples of patients with colorectal cancer undergoing surgery. METHODS We conducted a retrospective study of 160 patients with colorectal cancer who underwent surgery, and 42 healthy controls. The status of absolute monocyte count, MLR, NLR-PLR and PLT-NLR was calculated on the basis of blood samples obtained before and after surgery. Haematologic factors were examined in correlation with the type of tumour growth, tumour size, histological type, percentage of mucinous component, grade of malignancy, Tumour-Node-Metastasis stage, venous, lymphatic and perineural invasion of cancer cells, status of lymph node invasion and the presence of cancer cell deposits. The Kaplan-Meier method and the long-rank test were used to compare survival curves. To determine independent prognostic factors, univariate and multivariate Cox proportional hazards regression models were applied. RESULTS The PLT-NLR status was correlated with tumour size and the presence of perineural invasion (P = 0.015; P = -0.174, P = 0.037). Moreover, high NLR-PLR and PLR-NLR ratios in the blood samples obtained after surgery were positively associated with histological type of cancer and percentage of the mucinous component (NLR-PLR: P = 0.002; P = 0.009; PLR-NLR status: P = 0.002; P = 0.007). The analysis of 5-year disease-free survival showed that the MLR of whole blood obtained after surgery [HR = 2.903, 95%CI: (1.368-6.158), P = 0.005] and the status of lymph node metastasis [HR = 0.813, 95%CI: (0.653-1.013), P = 0.050] were independent prognostic factors in colorectal cancer patients. CONCLUSION The postoperative MLR in whole blood samples can be used as an independent prognostic factor in patients diagnosed with colorectal cancer.
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Affiliation(s)
- Katarzyna Jakubowska
- Department of Pathomorphology, Comprehensive Cancer Centre, Bialystok 15027, Poland
| | - Mariusz Koda
- Department of General Pathomorphology, Medical University of Bialystok, Bialystok 15027, Poland
| | - Małgorzata Grudzińska
- Department of General Pathomorphology, Medical University of Bialystok, Bialystok 15027, Poland
| | - Luiza Kańczuga-Koda
- Department of Pathomorphology, Comprehensive Cancer Centre, Bialystok 15027, Poland
| | - Waldemar Famulski
- Department of Medical Pathomorphology, Medical University of Bialystok, Bialystok 15027, Poland
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12
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Ha Y, Mohamed Ali MA, Petersen MM, Harmsen WS, Therneau TM, Lee HC, Ryoo BY, Bampoh S, Valles KA, Mady M, Missula VR, Prasai K, Roberts LR, Kim KM. Lymphocyte to monocyte ratio-based nomogram for predicting outcomes of hepatocellular carcinoma treated with sorafenib. Hepatol Int 2020; 14:776-787. [PMID: 32740886 DOI: 10.1007/s12072-020-10076-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/15/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The ability of the pretreatment lymphocyte to monocyte ratio (LMR) to predict outcomes of patients with hepatocellular carcinoma (HCC) receiving sorafenib is not conclusively determined. METHODS We retrospectively studied patients treated with sorafenib for HCC in two tertiary referral centres in Asia and North America. Primary endpoints were overall survival (OS) and progression-free survival (PFS). Predictive factors for the outcomes were determined by Cox proportional hazards models. A risk assessment tool was developed. RESULTS Compared to the North America cohort, the Asia cohort was more heavily pretreated (72.1% vs. 35.2%; p < 0.001), had higher hepatitis B virus infection (87.6% vs. 5.6%; p < 0.001), and more distant metastases (83.2% vs. 25.4%; p < 0.001). Lower monocyte count in the Asia cohort (median 462.7 vs. 600.0/μL; p = 0.023) resulted in a higher LMR (median 2.6 vs. 1.8; p < 0.001). High LMR was associated with a significantly higher OS [hazard ratio (HR) 0.88; 95% confidence interval (CI) 0.81‒0.97; p = 0.007]. This was confirmed in a sensitivity analysis including patients treated in Asia only (HR 0.89; 95% CI 0.81‒0.97; p = 0.010). An OS nomogram was constructed with the following variables selected in the multivariate Cox model: LMR, treatment location, previous treatment, performance status, alpha-fetoprotein, lymph node metastasis, and Child‒Pugh score. The concordance score was 0.71 (95% CI, 0.67‒0.75). LMR did not predict PFS. CONCLUSION LMR measured before sorafenib administration predicts OS in advanced HCC patients. Our OS nomogram, incorporating LMR, can be offered to clinicians to improve their ability to assess prognosis, strengthen the prognosis-based decision-making, and inform patients in the clinic.
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Affiliation(s)
- Yeonjung Ha
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.,Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.,Department of Gastroenterology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, South Korea
| | - Mohamed A Mohamed Ali
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Molly M Petersen
- Division of Biomedical Statistics and Informatics, Mayo Clinic Health Sciences Research, 205 Third Street SW, Rochester, MN, 55905, USA
| | - William S Harmsen
- Division of Biomedical Statistics and Informatics, Mayo Clinic Health Sciences Research, 205 Third Street SW, Rochester, MN, 55905, USA
| | - Terry M Therneau
- Division of Biomedical Statistics and Informatics, Mayo Clinic Health Sciences Research, 205 Third Street SW, Rochester, MN, 55905, USA
| | - Han Chu Lee
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Baek-Yeol Ryoo
- Department of Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sally Bampoh
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kenneth A Valles
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Mohamad Mady
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Venkata R Missula
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kritika Prasai
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Kang Mo Kim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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13
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Abdallah MA, Wongjarupong N, Hassan MA, Taha W, Abdalla A, Bampoh S, Onyirioha K, Nelson M, Glubranson LA, Wiseman GA, Fleming CJ, Andrews JC, Mahipal A, Roberts LR. The efficacy, safety, and predictors of outcomes of transarterial radioembolization for hepatocellular carcinoma: a retrospective study. Expert Rev Gastroenterol Hepatol 2020; 14:619-629. [PMID: 32490691 DOI: 10.1080/17474124.2020.1777856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Yttrium-90 transarterial radioembolization (TARE) is a safe, effective modality of locoregional therapy for intermediate and advanced-stage hepatocellular carcinoma (HCC). We aim to identify novel predictors of important outcomes of TARE therapy. METHODS A single-center retrospective study of 166 patients treated with TARE for HCC at Mayo Clinic Rochester between 2005-2015 and followed until December 2017. Multivariate logistic and stepwise regression analysis models were used to identify variables associated with overall survival (OS) and progression-free survival (PFS). RESULTS The median OS and the median PFS were12.9 (95% CI: 11.0-17.3), and 8 months (95% CI: 6-11), respectively. Macrovascular invasion (HR: 1.9 [1.3-2.8]), Child-Pugh score (CPS) B or C vs. A (HR: 1.8 [1.2-2.7]), Eastern Cooperative Oncology Group Performance status (ECOG-PS) 2 or 1 vs. 0 (HR: 1.6 [1.1-2.4]) and activity (A) of administered radiation dose (HR: 1.005[1.00-1.010), independently correlated with poorer OS. Infiltrative HCC (HR: 2.4 [1.3-4.5), macrovascular invasion (HR: 1.6 [1.1-2.7]), and high activity of administered radiation dose (HR: 1.005 [1.00-1.010) were associated with worse PFS. CONCLUSION In HCC patients treated with TARE; macrovascular invasion, the activity of radiation dose, CPS, ECOG-PS, and infiltrative HCC predict OS and PFS.
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Affiliation(s)
- Mohamed A Abdallah
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA.,Department of Internal Medicine, University of South Dakota Sanford School of Medicine , Sioux Falls, SD, USA
| | - Nicha Wongjarupong
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Mohamed A Hassan
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Wesam Taha
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Abubaker Abdalla
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Sally Bampoh
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Kristeen Onyirioha
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Morgan Nelson
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine , Sioux Falls, SD, USA
| | - Lyn A Glubranson
- Division of Vascular and Interventional Radiology, Department of Radiology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Gregory A Wiseman
- Division of Vascular and Interventional Radiology, Department of Radiology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Chad J Fleming
- Division of Vascular and Interventional Radiology, Department of Radiology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - James C Andrews
- Division of Vascular and Interventional Radiology, Department of Radiology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Amit Mahipal
- Division of Hematology and Oncology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA
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14
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Mao JX, Guo WY, Guo M, Liu C, Teng F, Ding GS. Acute rejection after liver transplantation is less common, but predicts better prognosis in HBV-related hepatocellular carcinoma patients. Hepatol Int 2020; 14:347-361. [PMID: 32140981 DOI: 10.1007/s12072-020-10022-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 02/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND With a novel finding of significantly lower incidence of acute rejection (AR) in patients with hepatocellular carcinoma (HCC) after liver transplantation, compared with those with benign end-stage liver disease (BESLD), in a large national cohort, we analyzed the correlations among the perioperative immuno-inflammation status, postoperative AR, and prognosis in HCC and BESLD patients with same etiology of hepatitis B virus (HBV), who underwent liver transplantation. METHODS Patients who underwent liver transplantation due to HBV-related HCC or BESLD and experienced AR between September 2008 and April 2017 were analyzed retrospectively and followed up until April 2018. HCC patients with AR were matched with those without AR according to tumor stage and immunosuppressant concentration, at a 1:3 ratio. Preoperative immuno-inflammation status and prognosis of patients in both groups were compared. RESULTS The overall incidences of AR in patients with HCC and BESLD were 8.60% and 10.61%, respectively. The postoperative 28-day incidence of AR was significantly lower in HCC compared with BESLD patients (3.23% vs 7.08%, p = 0.031). Compared with BESLD patients, the rejection activity index and perioperative CD4/CD8 ratio were significantly lower (p = 0.047 and p < 0.001, respectively), while platelet/lymphocyte ratio was significantly higher in HCC patients (p = 0.041). Later tumor stage in HCC patients was associated with higher systemic immuno-inflammation index, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, platelet/lymphocyte ratio, aspartate aminotransferase/lymphocyte ratio, C-reactive protein/albumin ratio and fibrinogen level, and lower CD4/CD8 ratio before transplantation. In HCC patients with AR, the percentage of regulatory T cells (CD4+/CD25+) and the level of IL-10 significantly decreased (p = 0.0023, < 0.0001, respectively), while Th1/Th2 ratio, levels of IFN-γ and IL-2 markedly increased before transplantation (p = 0.0018, 0.0059, 0.0416, respectively). Preoperative monocyte/lymphocyte ratio was an independent risk factor for overall and recurrence-free survival after liver transplantation in HCC patients (p = 0.025, < 0.001, respectively). The 1-, 3-, and 5-year survival rates were 76%, 71% and 53% in the AR group, and 67%, 37% and 25% in the non-AR group (p = 0.042). CONCLUSION Preoperative tumor-related immunosuppression may persist after liver transplantation in HCC patients, and reduce the incidence of AR. AR after liver transplantation may indicate a better prognosis in HCC patients.
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Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Meng Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China.,National Key Laboratory of Medical Immunology & Institute of Immunology, Navy Medical University, Shanghai, China
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China.
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China.
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15
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Liu L, Gong Y, Zhang Q, Cai P, Feng L. Prognostic Roles of Blood Inflammatory Markers in Hepatocellular Carcinoma Patients Taking Sorafenib. A Systematic Review and Meta-Analysis. Front Oncol 2020; 9:1557. [PMID: 32064238 PMCID: PMC7000550 DOI: 10.3389/fonc.2019.01557] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 12/23/2019] [Indexed: 12/24/2022] Open
Abstract
Objective: The purpose of this meta-analysis is to investigate the effectiveness of the prognostic roles of blood inflammatory markers in hepatocellular carcinoma (HCC) patients receiving sorafenib. Methods: We carried out a comprehensive literature search in four databases. Study endpoints, hazard ratios (HRs) and the associated 95% confidence intervals (CI) for clinical outcomes, which were to assess therapeutic efficacy, were extracted. This meta-analysis was conducted by Review Manager 5.3. Results: We summarized the available evidence from 18 studies with a total of 2,745 cases. The pooled results showed that the synthesized HR favored patients with low pretreatment NLR (neutrophil-to-lymphocyte ratio), which also indicated that HCC patients with a lower baseline NLR may have a better response to sorafenib than those with higher NLR (HR = 1.76, 95% CI [1.44, 2.15], P < 0.00001, I2 = 68%). Significance was also observed for the prognostic function of the PLR (platelet-to-lymphocyte ratio) of HCC patients treated with sorafenib (HR = 1.49, 95% CI [1.16, 1.93], P = 0.002, I2 = 0%, P = 0.65). The subgroup analysis revealed that different gene backgrounds play a prominent role in the source of heterogeneity. Interestingly, the predictive effect on OS (overall survival) was more pronounced as the NLR cutoff value increased. Notably, a significant predictive effect of NLR on the clinical outcome was detected in HCC patients treated with sorafenib compared to those treated with tivantinib. Conclusion: In conclusion, the present study reported promising predictive biomarkers for HCC patients and notably indicated that HCC patients with a lower baseline NLR and PLR may have a better response to sorafenib than those with higher ones. Further large-scale prospective studies are required to determine the optimal NLR and PLR cutoff values, which are important for identifying the dominant populations for sorafenib treatment.
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Affiliation(s)
- Lixing Liu
- Department of Chinese Medicine, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Gong
- The General Hospital of Shenyang Military Region, Shenyang, China
| | - Qinglin Zhang
- Department of Chinese Medicine, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Panpan Cai
- Department of Chinese Medicine, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Feng
- Department of Chinese Medicine, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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16
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Kong W, Xu H, Cheng J, Fang Z, Wang H, Zhang J, Wang X, Dai T, Gao Y. The Prognostic Role of a Combined Fibrinogen and Neutrophil-to-Lymphocyte Ratio Score in Patients with Resectable Hepatocellular Carcinoma: A Retrospective Study. Med Sci Monit 2020; 26:e918824. [PMID: 31929496 PMCID: PMC6977637 DOI: 10.12659/msm.918824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Inflammation and activation of the coagulation cascades have a role in the pathogenesis of malignancy, including hepatocellular carcinoma (HCC). This retrospective study aimed to investigate the prognostic role of the combined fibrinogen and neutrophil-to-lymphocyte ratio (F-NLR) in patients with resectable HCC. Material/Methods This retrospective study included 292 patients with HCC who underwent surgical resection. The receiver operating characteristic (ROC) curve was used to determine the cut-off value of preoperative fibrinogen (Fib) levels and the neutrophil-to-lymphocyte ratio (NLR). The. Hyperfibrinogenemia was >3.35 g/L, and an increased NLR was ≥2.47. The F-NLR was calculated for all patients. Kaplan-Meier survival curves, univariate analysis, multivariate analysis, and subgroup analysis were used to identify independent prognostic factors for overall survival (OS) and disease-free survival (DFS). The receiver operating characteristic (ROC) curve analysis of the F-NLR score and OS, according to the Barcelona Clinic Liver Cancer (BCLC) stage, was performed. Results Increased F-NLR scores were significantly associated with the presence of tumor thrombus (P=0.001), larger tumor diameter (P<0.001), vascular invasion (P<0.001), and increased BCLC stage (P<0.001). Multivariate analysis showed that the F-NLR score was an independent predictor of OS (P<0.001) and DFS (P=0.002). The prognostic role of F-NLR was significant for BCLC stage 0–I (P=0.004; P<0.001) and BCLC stage II–III (P=0.026; P=0.005) for OS and DFS, respectively. Conclusions In patients with resectable HCC, the combined F-NLR score, a new indicator of systemic inflammation, was an independent prognostic indicator.
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Affiliation(s)
- Weihao Kong
- Department of Emergency Surgery, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland).,Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland)
| | - Honghai Xu
- Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland).,Anhui Center for Surveillance of Bacterial Resistance, Heifei, Anhui, China (mainland)
| | - Jiongjiong Cheng
- Department of Emergency Surgery, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland).,Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland)
| | - Zheng Fang
- Department of Emergency Surgery, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland).,Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland)
| | - Hengyi Wang
- Department of Emergency Surgery, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland).,Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland)
| | - Jian Zhang
- Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China (mainland)
| | - Xingyu Wang
- Department of Emergency Surgery, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland).,Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland)
| | - Tianxing Dai
- Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China (mainland)
| | - Yufeng Gao
- Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland).,Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Heifei, Anhui, China (mainland)
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17
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Ahn J, Song E, Kim WG, Kim TY, Kim WB, Shong YK, Jeon MJ. Prognostic role of the lymphocyte-to-monocyte ratio for clinical outcomes of patients with progressive radioiodine-refractory differentiated thyroid carcinoma treated by sorafenib. Clin Endocrinol (Oxf) 2020; 92:71-76. [PMID: 31663136 DOI: 10.1111/cen.14120] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 10/26/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The lymphocyte-to-monocyte ratio (LMR) reflects the status of tumour-infiltrating immune cells and host immunity. The LMR has been reported as a prognostic marker in various cancers. The present study evaluated the role of the LMR as a prognostic marker in patients with progressive radioiodine-refractory (RAIR) differentiated thyroid carcinoma (DTC). DESIGN Retrospective cohort study. PATIENTS Forty patients with progressive RAIR DTC who were treated by sorafenib with available baseline complete blood cell count data. MEASUREMENTS We assessed the response rate, progression-free survival (PFS) and overall survival (OS). RESULTS The patients were divided into low and high LMR groups based on their baseline LMRs (<4, n = 22, 55% and ≥4, n = 18, 45%, respectively). There were no significant differences in baseline characteristics between the groups. The OS curves differed significantly based on the LMR. The median OS of the low LMR group was 24.3 months and that of the high LMR group was not reached until the end of observation period (P = .015). The PFS curves and median PFS also differed significantly based on the LMR values (P = .019). In multivariate analysis, low LMR was an independent risk factor for all-cause mortality in patients with progressive RAIR DTC (hazard ratio, 2.64; 95% confidence interval: 1.04-6.72, P = .041). CONCLUSION A low LMR was associated with poor response rate, PFS and OS in patients with progressive RAIR DTC treated with sorafenib. Thus, LMR could be a simple prognostic biomarker in patients with progressive RAIR DTC.
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Affiliation(s)
- Jonghwa Ahn
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eyun Song
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Kee Shong
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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18
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Shen Y, Wang H, Chen X, Li W, Chen J. Prognostic significance of lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization and radiofrequency ablation. Onco Targets Ther 2019; 12:7129-7137. [PMID: 31564897 PMCID: PMC6731523 DOI: 10.2147/ott.s217935] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/23/2019] [Indexed: 12/23/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) ranks fifth among malignancies globally. Previous studies have shown that systemic inflammatory response, platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are associated with poor prognosis of various types of cancer. Materials and methods Radiofrequency ablation (RFA) was performed using an internal cooling electrode with a 2- or 3-cm exposed tip. The LMR was calculated as the ratio of lymphocytes to monocytes. In order to explore the influence of pretreatment with PLR and LMR on survival of HCC patients undergoing transcatheter arterial chemoembolization (TACE) and RFA, 204 cases with HCC which accepted RFA and TACE were retrospectively analyzed and assigned into 2 groups based on optimal cutoff values for LMR (low: ≤2.13 or high: >2.13) and PLR (low: ≤95.65 or high: >95.65). Results Patients with a lower PLR had a longer overall survival (OS) compared to those with a higher PLR (median OS, 20 versus 13 months), and patients with a higher LMR had a longer OS than those with a lower LMR (OS, 22 versus 10 months). Multivariate logistic regression analysis was performed using Cox proportional hazards regression analysis for multiple prognostic factors and identified PLR and LMR as prognostic factors for OS of HCC cases. Conclusion We conclude that PLR and LMR, whose detection is generally available and affordable, may be novel noninvasive circulating markers to potentially assist doctors assess the prognosis of patients.
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Affiliation(s)
- Yanjun Shen
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, People's Republic of China
| | - Huige Wang
- Department of Gynecology,Wangjing Hospital of Chinese Academy of Chinese Medical, Beijing 100102, People's Republic of China
| | - Xiangmei Chen
- Department of Pathology, Beijing Ditan Hospital, Capital Medical Uiversity, Beijing 100015, People's Republic of China
| | - Wendong Li
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, People's Republic of China
| | - Jinglong Chen
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, People's Republic of China
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19
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Mao JX, Teng F, Liu C, Yuan H, Dong JY, Fu H, Ding GS, Guo WY. Immunometabolic inflammation and hepatocellular carcinoma. Hepatobiliary Pancreat Dis Int 2019; 18:298-300. [PMID: 31027911 DOI: 10.1016/j.hbpd.2019.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/11/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Hang Yuan
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Jia-Yong Dong
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Hong Fu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China.
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20
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Kadiyoran C, Zengin O, Cizmecioglu HA, Tufan A, Kucuksahin O, Cure MC, Cure E, Kucuk A, Ozturk MA. Monocyte to Lymphocyte Ratio, Neutrophil to Lymphocyte Ratio, and Red Cell Distribution Width are the Associates with Gouty Arthritis. ACTA MEDICA (HRADEC KRALOVE) 2019; 62:99-104. [PMID: 31663502 DOI: 10.14712/18059694.2019.132] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neutrophils, monocytes, and macrophages activations are associated with a gout attack. Monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), red cell distribution width (RDW), and mean platelet volume (MPV) are well-known inflammation markers. In this study, we aimed to investigate whether they could be a predictive marker to the gout attack. MATERIAL AND METHODS A hundred and ten gout patients (male/female, 86/24) and 90 (male/female, 64/26) age-, gender-, and body mass index-matched volunteer controls were included in the study. Blood samples were obtained in the intercritical and attack period of the patients. Hemogram, serum uric acid (SUA), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) values were studied. RESULTS In the attack period NLR (p < 0.001), PLR (p < 0.05), MLR (p < 0.001), RDW (p < 0.05), MPV (p < 0.05), ESR (p < 0.001), CRP (p < 0.001) and SUA (p < 0.001) values were significantly higher than intercritical period values. According to the results of regression analysis; There was an independent strong relationship between the gout attack and SUA, (Beta [β] = 0.352, p < 0.001), ESR (β = 0.329, p < 0.001), CRP (β = 0.286, p < 0.001), MLR (β = 0.126, p < 0.001), RDW (β = 0.100, p = 0.003) and NLR (β = 0.082, p = 0.014). CONCLUSIONS MLR, RDW, and NLR may be a strong predictive marker for a gout attack. MPV and PLR values in the gout attack may be associated with systemic inflammation.
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Affiliation(s)
- Cengiz Kadiyoran
- Department of Radiology, Necmettin Erbakan University, Konya, Turkey
| | - Orhan Zengin
- Department of Rheumatology, Adiyaman Training and Research Hospital, Adiyaman, Turkey
| | | | - Abdurrahman Tufan
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Orhan Kucuksahin
- Division of Rheumatology, Department of Internal Medicine, Ankara Liv Hospital, Kavaklidere, Ankara, Turkey
| | | | - Erkan Cure
- Department of Internal Medicine, Ota&Jinemed Hospital, Istanbul, Turkey.
| | - Adem Kucuk
- Division of Rheumatology, Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Akif Ozturk
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
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