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Zhang J, Luo X, Fan Y, Zhou W, Ma S, Kang Y, Yang W, Geng X, Zhang H, Deng F. Development and validation of a LASSO prediction model for cisplatin induced nephrotoxicity: a case-control study in China. BMC Nephrol 2024; 25:194. [PMID: 38862914 PMCID: PMC11167850 DOI: 10.1186/s12882-024-03623-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 05/28/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Early identification of high-risk individuals with cisplatin-induced nephrotoxicity (CIN) is crucial for avoiding CIN and improving prognosis. In this study, we developed and validated a CIN prediction model based on general clinical data, laboratory indications, and genetic features of lung cancer patients before chemotherapy. METHODS We retrospectively included 696 lung cancer patients using platinum chemotherapy regimens from June 2019 to June 2021 as the traing set to construct a predictive model using Absolute shrinkage and selection operator (LASSO) regression, cross validation, and Akaike's information criterion (AIC) to select important variables. We prospectively selected 283 independent lung cancer patients from July 2021 to December 2022 as the test set to evaluate the model's performance. RESULTS The prediction model showed good discrimination and calibration, with AUCs of 0.9217 and 0.8288, sensitivity of 79.89% and 45.07%, specificity of 94.48% and 94.81%, in the training and test sets respectively. Clinical decision curve analysis suggested that the model has value for clinical use when the risk threshold ranges between 0.1 and 0.9. Precision-Recall (PR) curve shown in recall interval from 0.5 to 0.75: precision gradually declines with increasing Recall, up to 0.9. CONCLUSIONS Predictive models based on laboratory and demographic variables can serve as a beneficial complementary tool for identifying high-risk populations with CIN.
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Affiliation(s)
- Jingwei Zhang
- Department of Blood Transfusion, Chengdu Second People's Hospital, Chengdu, China
| | - Xuyang Luo
- Department of Nephrology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Department of Nephrology, Sichuan Provincial People's Hospital Jinniu Hospital, Chengdu Jinniu District People's Hospital, Chengdu, China
| | - Yi Fan
- Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Wei Zhou
- Department of Nephrology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Shijie Ma
- Department of Nephrology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Yuwei Kang
- Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Wei Yang
- Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaoxia Geng
- Department of Elderly Infection, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Heping Zhang
- Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
| | - Fei Deng
- Department of Nephrology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
- Department of Nephrology, Sichuan Provincial People's Hospital Jinniu Hospital, Chengdu Jinniu District People's Hospital, Chengdu, China.
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
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Sun Y, Zhao J, Du J, Li Y, Ding F, Zhao W. Clinical implications and predictive value of the creatinine‑cystatin C ratio in patients with multiple myeloma and renal impairment. Oncol Lett 2024; 27:134. [PMID: 38362231 PMCID: PMC10867728 DOI: 10.3892/ol.2024.14267] [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: 10/24/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024] Open
Abstract
The creatinine (Cr)-cystatin C ratio (CCR) at the time of cancer diagnosis is associated with survival; however, to the best of our knowledge, the association between this ratio and mortality in patients with multiple myeloma and renal impairment (RI) is unclear. Therefore, the present study aimed to assess this association, as well as disease prognosis and the clinical significance of the CCR in patients with multiple myeloma and RI. The present retrospective study included 191 patients diagnosed with multiple myeloma and RI between 2012 and 2022. The predictive value of the CCR was evaluated using area under the receiver operating characteristic curve (AUC) values. The factors affecting overall survival (OS) were assessed using uni- and multivariate logistic regression analyses. The effect of the CCR on survival was evaluated using a Cox regression model and the Kaplan-Meier method. There was a significant association between low CCR and poor progression-free survival (PFS) and overall survival (OS). The 1-, 2- and 3-year PFS and OS rates in patients with a low CCR were significantly lower than those in patients with a high CCR. The 1-, 2- and 3-year AUC values of the CCR were 0.712, 0.764 and 0.746 respectively. Multivariate analysis revealed sex, age, Cr levels, CCR and C-reactive protein levels as independent prognostic factors affecting OS rates. The CCR is a potential prognostic indicator in patients with multiple myeloma with RI and is associated with clinical stages.
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Affiliation(s)
- Yixuan Sun
- Department of Hematology, Shandong Provincial Hospital Affiliated with Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Junfeng Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China
| | - Jiachen Du
- Department of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Ying Li
- Department of Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China
| | - Fangjie Ding
- Department of Radiation Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong First Medical University, Jinan, Shandong 250013, P.R. China
| | - Wenbo Zhao
- Department of Hematology, Shandong Provincial Hospital Affiliated with Shandong First Medical University, Jinan, Shandong 250021, P.R. China
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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Min B, Yun SR, Yoon SH, Kim JD, Hwang WJ, Hwang WM, Park Y. Comparison of the association intensity of creatinine and cystatin C with hyperphosphatemia and hyperparathyroidism in patients with chronic kidney disease. Sci Rep 2023; 13:3855. [PMID: 36890290 PMCID: PMC9995313 DOI: 10.1038/s41598-023-31048-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/06/2023] [Indexed: 03/10/2023] Open
Abstract
Herein, we compared the association intensity of estimated glomerular filtration rate (eGFR) equations using creatinine (Cr) or cystatin C (CysC) with hyperphosphatemia and secondary hyperparathyroidism occurrence, which reflect the physiological changes occurring during chronic kidney disease (CKD) progression. This study included 639 patients treated between January 2019 and February 2022. The patients were divided into low- and high-difference groups based on the median value of the difference between the Cr-based eGFR (eGFRCr) and CysC-based eGFR (eGFRCysC). Sociodemographic and laboratory factors underlying a high difference between eGFRCr and eGFRCysC were analyzed. The association intensity of eGFRCr, eGFRCysC and both Cr- and CysC-based eGFR (eGFRCr-CysC) was compared using the area under the receiver operating characteristic curve (AuROC) values for hyperphosphatemia and hyperparathyroidism occurrence in the overall cohort and the low- and high-difference groups. Age > 70 years and CKD grade 3 based on eGFRCr were significant factors affecting the high differences. eGFRCysC and eGFRCr-CysC showed higher AuROC values than that of eGFRCr, especially in the high-difference group and in patients with CKD grade 3. Our results show that CysC should be evaluated in patients with significant factors, including age > 70 years and CKD grade 3, to accurately assess kidney function to better determine the physiological changes in CKD progression and predict prognosis accurately.
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Affiliation(s)
- Byungju Min
- Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea
| | - Sung-Ro Yun
- Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea
| | - Se-Hee Yoon
- Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea
| | - Jong-Dai Kim
- Division of Endocrinology, Department of Internal Medicine, Konyang University Hospital, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea
| | - Wan Jin Hwang
- Konyang University Myunggok Medical Research Institute, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea
| | - Won Min Hwang
- Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea. .,Konyang University Myunggok Medical Research Institute, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea.
| | - Yohan Park
- Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea. .,Konyang University Myunggok Medical Research Institute, Gwanjeodong-Ro 158, Seo-Gu, Daejeon, 35365, Republic of Korea.
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Li Y, Zhang J, Wang B, Zhang H, He J, Wang K. A nomogram based on clinicopathological features and serological indicators predicting breast pathologic complete response of neoadjuvant chemotherapy in breast cancer. Sci Rep 2021; 11:11348. [PMID: 34059778 PMCID: PMC8167133 DOI: 10.1038/s41598-021-91049-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 05/17/2021] [Indexed: 02/04/2023] Open
Abstract
A single tumor marker is not enough to predict the breast pathologic complete response (bpCR) after neoadjuvant chemotherapy (NAC) in breast cancer patients. We aimed to establish a nomogram based on multiple clinicopathological features and routine serological indicators to predict bpCR after NAC in breast cancer patients. Data on clinical factors and laboratory indices of 130 breast cancer patients who underwent NAC and surgery in First Affiliated Hospital of Xi'an Jiaotong University from July 2017 to July 2019 were collected. Multivariable logistic regression analysis identified 11 independent indicators: body mass index, carbohydrate antigen 125, total protein, blood urea nitrogen, cystatin C, serum potassium, serum phosphorus, platelet distribution width, activated partial thromboplastin time, thrombin time, and hepatitis B surface antibodies. The nomogram was established based on these indicators. The 1000 bootstrap resampling internal verification calibration curve and the GiViTI calibration belt showed that the model was well calibrated. The Brier score of 0.095 indicated that the nomogram had a high accuracy. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was 0.941 (95% confidence interval: 0.900-0.982) showed good discrimination of the model. In conclusion, this nomogram showed high accuracy and specificity and did not increase the economic burden of patients, thereby having a high clinical application value.
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Affiliation(s)
- Yijun Li
- grid.43169.390000 0001 0599 1243Department of Breast Surgery, First Affiliate Hospital, Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061 People’s Republic of China
| | - Jian Zhang
- grid.43169.390000 0001 0599 1243Department of Breast Surgery, First Affiliate Hospital, Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061 People’s Republic of China
| | - Bin Wang
- grid.43169.390000 0001 0599 1243Department of Breast Surgery, First Affiliate Hospital, Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061 People’s Republic of China
| | - Huimin Zhang
- grid.43169.390000 0001 0599 1243Department of Breast Surgery, First Affiliate Hospital, Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061 People’s Republic of China
| | - Jianjun He
- grid.43169.390000 0001 0599 1243Department of Breast Surgery, First Affiliate Hospital, Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061 People’s Republic of China
| | - Ke Wang
- grid.43169.390000 0001 0599 1243Department of Breast Surgery, First Affiliate Hospital, Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061 People’s Republic of China
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Transcriptomic Profiling Identifies Differentially Expressed Genes in Palbociclib-Resistant ER+ MCF7 Breast Cancer Cells. Genes (Basel) 2020; 11:genes11040467. [PMID: 32344635 PMCID: PMC7230561 DOI: 10.3390/genes11040467] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/17/2020] [Accepted: 04/18/2020] [Indexed: 12/18/2022] Open
Abstract
Acquired resistance to cyclin-dependent kinases 4 and 6 (CDK4/6) inhibition in estrogen receptor-positive (ER+) breast cancer remains a significant clinical challenge. Efforts to uncover the mechanisms underlying resistance are needed to establish clinically actionable targets effective against resistant tumors. In this study, we sought to identify differentially expressed genes (DEGs) associated with acquired resistance to palbociclib in ER+ breast cancer. We performed next-generation transcriptomic RNA sequencing (RNA-seq) and pathway analysis in ER+ MCF7 palbociclib-sensitive (MCF7/pS) and MCF7 palbociclib-resistant (MCF7/pR) cells. We identified 2183 up-regulated and 1548 down-regulated transcripts in MCF7/pR compared to MCF7/pS cells. Functional analysis of the DEGs using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) database identified several pathways associated with breast cancer, including ‘cell cycle’, ‘DNA replication’, ‘DNA repair’ and ‘autophagy’. Additionally, Ingenuity Pathway Analysis (IPA) revealed that resistance to palbociclib is closely associated with deregulation of several key canonical and metabolic pathways. Further studies are needed to determine the utility of these DEGs and pathways as therapeutics targets against ER+ palbociclib-resistant breast cancer.
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