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Utsumi M, Inagaki M, Kitada K, Tokunaga N, Yunoki K, Sakurai Y, Okabayashi H, Hamano R, Miyaso H, Tsunemitsu Y, Otsuka S. Albumin-Lymphocyte-Globulin-C-Reactive Protein Index as a Novel Prognostic Biomarker for Hepatocellular Carcinoma after Hepatectomy. Dig Surg 2024:1-10. [PMID: 39038447 DOI: 10.1159/000540067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION This study evaluated the performance of the albumin-lymphocyte-globulin-C-reactive protein (CRP) (ALGC) index as a novel prognostic biomarker for hepatocellular carcinoma (HCC) after hepatectomy. METHODS Patients (n = 178) who underwent hepatectomy for HCC (July 2010-December 2021) were analyzed. The ALGC index was calculated as ([albumin × lymphocyte]/[CRP × globulin × 104]). Patients were divided into a low ALGC group (<1.82; n = 81) and a high ALGC group (≥1.82; n = 97). The association of the ALGC index with survival was assessed by univariate and multivariate analyses. RESULTS The median overall survival (OS) was 100 (range: 1-149) months with 1-, 3-, and 5-year OS rates of 91.6%, 81.2%, and 64.2%, respectively. In univariate analysis, ALGC index (<1.82), alpha-fetoprotein (≥25 ng/mL), tumor size (≥3.5 cm), microvascular invasion, and multiple tumors were associated with shorter OS. ALGC index (<1.82) (hazard ratio [95% confidence interval]) (2.48 [1.407-4.513]; p = 0.001) and multiple tumors (1.92 [1.070-3.356]; p = 0.029) were independent predictors of OS in multivariate analysis. CONCLUSION ALGC index is a novel prognostic biomarker for HCC after hepatectomy. It may assist in treatment stratification and better management of patients with HCC.
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Affiliation(s)
- Masashi Utsumi
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
| | - Masaru Inagaki
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
| | - Koji Kitada
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
| | - Naoyuki Tokunaga
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
| | - Kosuke Yunoki
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
| | - Yuya Sakurai
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
| | | | - Ryosuke Hamano
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
| | - Hideaki Miyaso
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
| | | | - Shinya Otsuka
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama, Japan
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Maeda D, Matsue Y, Kagiyama N, Fujimoto Y, Sunayama T, Dotare T, Nakade T, Jujo K, Saito K, Kamiya K, Saito H, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Wada H, Hiki M, Kasai T, Nagamatsu H, Ozawa T, Izawa K, Yamamoto S, Aizawa N, Wakaume K, Oka K, Momomura SI, Minamino T. Lymphocyte-to-C-reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis. ESC Heart Fail 2024. [PMID: 38984563 DOI: 10.1002/ehf2.14972] [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: 12/24/2023] [Revised: 06/15/2024] [Accepted: 06/28/2024] [Indexed: 07/11/2024] Open
Abstract
AIMS In heart failure (HF), inflammation is linked to malnutrition and impaired physical function. In this study, we aimed to assess how novel nutritional-inflammatory markers and lymphocyte-to-C-reactive protein ratio (LCR) and score (LCS) are associated with the nutritional status, physical function, and prognosis of patients with HF. METHODS AND RESULTS This study was a secondary analysis of the FRAGILE-HF study, a prospective observational study conducted across 15 hospitals in Japan. We included 1212 patients (mean age, 80.2 ± 7.8 years; 513 women) hospitalized with HF, who were classified into three groups according to their LCS score: 0 (n = 498), 1 (n = 533), and 2 (n = 181). Baseline data on physical examination, echocardiography, blood test results (including lymphocyte counts and CRP levels), and oral medication usage were collected in a clinically compensated state before discharge. Nutritional status and physical function were evaluated using several indices and tests. The primary outcome of this study was all-cause death within 2 years. Univariate and multivariate linear regression analyses were performed to evaluate the associations among the nutritional status, physical function, and LCR/LCS. Patients with an LCS score of 2 were older and had a lower body mass index than those in the other two groups. Multivariate linear regression analysis revealed that lower LCR and higher LCS were independently associated with worse nutritional status, lower handgrip strength, shorter physical performance battery score, and shorter 6-min walk distance. At 2 years, all-cause death occurred in 254 patients: 86 (17.6%), 113 (21.5%), and 55 (30.9%) with LCS scores of 0, 1, and 2, respectively (P = 0.001). Cox proportional hazards analysis revealed that LCR and LCS were significantly associated with 2-year mortality even after adjusting for the conventional risk model (LCS score, 0 vs. 2: hazard ratio, 1.64; 95% confidence interval [CI]; 1.14-2.35; P = 0.007; log-transformed LCR: hazard ratio, 0.88; 95% CI, 0.81-0.95; P = 0.002). LCR yielded additional prognostic predictability compared with the conventional risk model (continuous net reclassification improvement, 0.153; 95% CI, 0.007-0.299; P = 0.041). CONCLUSIONS LCR and LCS emerge as potential predictors of nutritional status, physical function, and prognosis in older patients with HF.
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Affiliation(s)
- Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan
- Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan
| | - Yudai Fujimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taisuke Nakade
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Centre Hospital, Tokyo, Japan
| | - Kazuya Saito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Hiroshi Saito
- Department of Rehabilitation, Kameda Medical Centre, Chiba, Japan
| | - Yuki Ogasahara
- Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaaki Konishi
- Division of Cardiology, Yokohama City University Medical Centre, Yokohama, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
- Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe-shi, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe-shi, Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Centre, Jichi Medical University, Saitama, Japan
| | - Masaru Hiki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Ozawa
- Department of Rehabilitation, Odawara Municipal Hospital, Odawara, Japan
| | - Katsuya Izawa
- Department of Rehabilitation, Matsui Heart Clinic, Saitama, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Nagano, Japan
| | - Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Kazuki Wakaume
- Rehabilitation Centre, Kitasato University Medical Centre, Saitama, Japan
| | - Kazuhiro Oka
- Department of Rehabilitation, Saitama Citizens Medical Centre, Saitama, Japan
| | | | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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Seo YJ, Kim KE, Jeong WK, Baek SK, Bae SU. Effect of preoperative pan-immune-inflammation value on clinical and oncologic outcomes after colorectal cancer surgery: a retrospective study. Ann Surg Treat Res 2024; 106:169-177. [PMID: 38435496 PMCID: PMC10902619 DOI: 10.4174/astr.2024.106.3.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 03/05/2024] Open
Abstract
Purpose Surgical resection, the primary treatment for colorectal cancer (CRC), is often linked with postoperative complications that adversely affect the overall survival rates (OS). The pan-immune-inflammation value (PIV), a novel biomarker, is promising in evaluating cancer prognoses. We aimed to explore the impact of preoperative immune inflammation status on postoperative and long-term oncological outcomes in patients with CRC. Methods A retrospective analysis of 203 patients with CRC who underwent surgery (January 2016-June 2020) was conducted. The preoperative PIV was calculated as [(neutrophil count + platelet count + monocyte count) / lymphocyte counts]. The PIV optimal cutoff value was determined based on the OS using the Contal and O'Quigley methods. Results A PIV value ≥155.90 was defined as high. Patients were categorized into low-PIV (n = 85) and high-PIV (n = 118) groups. Perioperative clinical outcomes (total operation time, time to gas out, sips of water, soft diet, and hospital stay) were not significantly different between the groups. The high-PIV group exhibited more postoperative complications (P = 0.024), and larger tumor size compared with the low-PIV group. Multivariate analysis identified that American Society of Anesthesiologists grade III (P = 0.046) and high-PIV (P = 0.049) were significantly associated with postoperative complications. The low-PIV group demonstrated higher OS (P = 0.001) and disease-free survival rates (DFS) (P = 0.021) compared with the high-PIV group. Advanced N stage (P = 0.005) and high-PIV levels (P = 0.047) were the identified independent prognostic factors for OS, whereas advanced N stage (P = 0.045) was an independent prognostic factor for DFS. Conclusion Elevated preoperative PIV was associated with an increased incidence of postoperative complications and served as an independent prognostic factor for OS.
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Affiliation(s)
- Yun Ju Seo
- Department of Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Kyeong Eui Kim
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Woon Kyung Jeong
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Seong Kyu Baek
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Sung Uk Bae
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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Shi Z, Zhu S, Jin Y, Qi L, Zhou M, Zhou Z, Zhang J, Liu B, Shen J. Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving Radiotherapy. J Hepatocell Carcinoma 2024; 11:305-316. [PMID: 38348098 PMCID: PMC10860807 DOI: 10.2147/jhc.s452424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
Background Stereotactic body radiotherapy (SBRT) has emerged as an alternative approach for patients with hepatocellular carcinoma (HCC), and we aim to find potential prognostic biomarkers for HCC patients who received SBRT. Methods In this study, we retrospectively analyzed HCC patients who underwent SBRT in our institution from January 2018 to December 2022. The inflammatory parameters, along with baseline patients' characteristics were collected to elucidate the potential relationship with survival benefits and liver toxicities. Results Overall, 35 patients were enrolled in our study. For the efficacy population (25 patients who underwent SBRT for primary liver lesions), the objective response rate (ORR) and disease control rate (DCR) were 60% and 100%, respectively. The median progression-free survival (PFS) was 9.9 months [95% confidence interval (CI) 5.6-14.1 months], and the median overall survival (OS) was 18.5 months (95% CI 14.2-22.8 months). We further confirmed that higher baseline lymphocyte-C-reactive protein ratio (LCR) (≥2361.11) was positively related to both longer PFS (12.0 vs 4.3 months, P = 0.002) and OS (21.9 vs 11.4 months, P = 0.022). Moreover, patients with diabetes and higher alpha-fetoprotein (AFP) (≥400 ng/mL) were also found to be associated with worse OS. The most common hepatotoxicity was elevated gamma-glutamyl transferase (GGT) (84.0%). Conclusion In conclusion, for patients with inoperable HCC, SBRT resulted in satisfactory local control, survival benefits, and acceptable liver toxicity. Pre-radiotherapy LCR might be an independent and readily available predictor for survival, which facilitates us to find the most appropriate treatment options.
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Affiliation(s)
- Zhan Shi
- Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
| | - Sihui Zhu
- The Comprehensive Cancer Centre of Nanjing International Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
| | - Yuncheng Jin
- Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
| | - Liang Qi
- Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
| | - Mingzhen Zhou
- Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
| | - Ziyan Zhou
- Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
| | - Juan Zhang
- Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
| | - Baorui Liu
- Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
| | - Jie Shen
- Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China
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Liu X, Mu Y. Lymphocyte to C-Reactive Protein Ratio as an Early Biomarker to Distinguish Sepsis from Pneumonia in Neonates. J Inflamm Res 2023; 16:3509-3517. [PMID: 37608883 PMCID: PMC10441656 DOI: 10.2147/jir.s424897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023] Open
Abstract
Background Neonatal sepsis is an acute and severe disease that seriously threatens the life and health of newborns. Neonates with pneumonia may also have unrecognized neonatal sepsis. Early diagnosis of neonatal sepsis is beneficial for early treatment. This study aimed to evaluate the clinical significance of the lymphocyte-to-C-reactive protein ratio (LCR) as an early biomarker to distinguish sepsis from pneumonia. Methods This retrospective study enrolled 1635 neonates with pneumonia from February 2016 to March 2022. Among them, 182 cases were diagnosed with sepsis based on the positive blood culture results. Clinical and laboratory data were extracted from the electronic medical records. LCR was calculated as the ratio of the total lymphocyte count (×109 cells/L) to the C-reactive protein level (mg/L). Binary logistic regression analysis was conducted to evaluate the clinical significance of LCR as an early biomarker in distinguishing sepsis from pneumonia. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic value of LPCR in sepsis cases. All statistical analyses were conducted using Statistical Product and Service Solutions, version 24.0. Results The neonates with pneumonia combined with sepsis had a lower LCR than that of the neonates with pneumonia. Further analysis showed that the prevalence of neonatal pneumonia combined with sepsis was significantly higher in the low-LCR group than in the high-LCR group (20.7% vs 5.5%, P < 001). Binary logistic regression revealed that LCR was an independent risk factor for identifying pneumonia combined with sepsis. The ROC curve analysis revealed that LCR had better power than the lymphocyte count and CRP level individually in diagnosing neonatal pneumonia combined with sepsis (0.72 vs 0.65 vs 0.66, P < 0.001), with 62% sensitivity and 72% specificity. Conclusion LCR can be a potential early biomarker in distinguishing neonates with sepsis from those with pneumonia.
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Affiliation(s)
- Xinrui Liu
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, People’s Republic of China
| | - Yuan Mu
- Institute of Thermology, Henan Institute of Metrology and Testing Sciences, Zhengzhou, People’s Republic of China
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